| Mr Kevin Jon Penner, CCC-SLP | |
|
6270 N Government Way, Dalton Gardens, ID 83815-9214 | |
| (208) 666-0611 | |
| (208) 664-0566 |
| Full Name | Mr Kevin Jon Penner |
|---|---|
| Gender | Male |
| Speciality | Speech-language Pathologist |
| Location | 6270 N Government Way, Dalton Gardens, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982377073 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | SLP-4868 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Kevin Jon Penner, CCC-SLP 6270 N Government Way, Dalton Gardens, ID 83815-9214 Ph: (208) 666-0611 | Mr Kevin Jon Penner, CCC-SLP 6270 N Government Way, Dalton Gardens, ID 83815-9214 Ph: (208) 666-0611 |
Savannah Lacy Lovitt, MS CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6270 N Government Way, Dalton Gardens, ID 83815 Phone: 208-666-0611 | |
Lauren Alyssa Burgheimer, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6270 N Government Way, Dalton Gardens, ID 83815 Phone: 208-666-0611 | |
Collin Hubbard, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 6270 N Government Way, Dalton Gardens, ID 83815 Phone: 714-658-2705 |