Pennock, Blake Robert

Pennock, Blake Robert is an sole proprietor health care provider with primary practice located at 1501 S Yale St Ste 250 , Flagstaff AZ 86001-7336. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Chiropractic Providers / Chiropractor. Chiropractic Providers / Chiropractor is his primary health care specialty. Pennock, Blake Robert can be contacted via phone (928) 557-0707.

Contact Information

Primary practice address
1501 S Yale St Ste 250 Flagstaff AZ 86001-7336
Phone: (928) 557-0707
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Chiropractic Providers / Chiropractor 111N00000X 8787 Arizona

Profile Details

NPI number 1053877159
LBN Legal business name Pennock, Blake Robert
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2019
Last updated Feb 22nd, 2019 - about 7 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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