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Search › Arizona › 111N00000X

Blake Pennock, DC

NPI 1053877159 · on the registry since 2019 · sole proprietor

Practice

Address
1501 S Yale St Ste 250
Flagstaff, AZ 86001
Phone
(928) 557-0707
Organisation at this address
Naz Mua Llc
Lhcg Lxxvii, Llc
Elite Uc Care Llc
Proforma Health Pllc
Munderloh Medical Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
19

Registry record

Primary taxonomy
111N00000X
111N00000X
Also registered as
390200000X
Licence states on file
AZ
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-02-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona