Individual provider · Type 1 NPI

Kevin Pennell, L.M.T.

Massage Therapist · Portland, ME

NPI number 1386064848 Active

Practice location

55 Warren Ave
Portland, ME 04103-1103

Call (207) 577-1010 Map

Mailing address

95 Boothby Ave
South Portland, ME 04106-4628

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMT4495 (ME)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1386064848

Kevin Pennell, L.M.T.'s National Provider Identifier is 1386064848, issued on Apr 23, 2014. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, ME. The record was last updated on Apr 23, 2014.