Provider Demographics
NPI:1972840791
Name:PENLEY, JOEL (DC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:PENLEY
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 1:44D HUNTER BROOK LN
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-5858
Mailing Address - Country:US
Mailing Address - Phone:518-798-3237
Mailing Address - Fax:518-798-3238
Practice Address - Street 1:88 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-1700
Practice Address - Country:US
Practice Address - Phone:518-798-3237
Practice Address - Fax:518-798-3238
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor