Provider Demographics
NPI:1679533731
Name:PENNEY, JAMES MARTIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARTIN
Last Name:PENNEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLD COMMON RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-3208
Mailing Address - Country:US
Mailing Address - Phone:508-832-4303
Mailing Address - Fax:508-832-4958
Practice Address - Street 1:2 OLD COMMON RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-3208
Practice Address - Country:US
Practice Address - Phone:508-832-4303
Practice Address - Fax:508-832-4958
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1525111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
Y36049OtherBLUE CROSS
Y36049OtherBLUE CROSS
Y36065Medicare ID - Type Unspecified