Pennington, Blake

Pennington, Blake is an individual health care provider with primary practice located at 2548 Lemay Ferry Rd , Saint Louis MO 63125-3131. He recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as his primary health care specialty. Pennington, Blake can be contacted via phone (314) 416-1415.

Contact Information

Primary practice address
2548 Lemay Ferry Rd Saint Louis MO 63125-3131
Phone: (314) 416-1415
Fax: (314) 416-1495
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X 2015031321 Missouri

Profile Details

NPI number 1366812679
LBN Legal business name Pennington, Blake
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2015
Last updated Sep 29th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366812679 NPPES
Missouri Other 2015031321 STATE OF MISSOURI HEARING AID DISPENSER PERMIT

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