Provider Demographics
NPI:1851589626
Name:LANA C. PENNELL, D.C.
Entity Type:Organization
Organization Name:LANA C. PENNELL, D.C.
Other - Org Name:HEALTHSTAR CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANA
Authorized Official - Middle Name:CAY
Authorized Official - Last Name:PENNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:816-350-1100
Mailing Address - Street 1:10707 E WINNER RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64052-3759
Mailing Address - Country:US
Mailing Address - Phone:816-350-1100
Mailing Address - Fax:816-252-5400
Practice Address - Street 1:10707 E WINNER RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-3759
Practice Address - Country:US
Practice Address - Phone:816-350-1100
Practice Address - Fax:816-252-5400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCE006674111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOL130000Medicare PIN