Provider Demographics
NPI:1619184462
Name:PENNINGTON ENTERPRISES, L.L.C.
Entity Type:Organization
Organization Name:PENNINGTON ENTERPRISES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-688-0097
Mailing Address - Street 1:2450 E 5TH AVE
Mailing Address - Street 2:UNIT K
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4268
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:94 W 11TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-3616
Practice Address - Country:US
Practice Address - Phone:303-820-3336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty