Provider Demographics
NPI:1245358886
Name:PENNINGTON CHIROPRACTIC, PC LLC
Entity type:Organization
Organization Name:PENNINGTON CHIROPRACTIC, PC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PENNINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-493-5444
Mailing Address - Street 1:7120 E ORCHARD RD
Mailing Address - Street 2:STE 250
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1731
Mailing Address - Country:US
Mailing Address - Phone:720-493-5444
Mailing Address - Fax:720-493-2021
Practice Address - Street 1:7120 E ORCHARD RD
Practice Address - Street 2:STE 250
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111-1731
Practice Address - Country:US
Practice Address - Phone:720-493-5444
Practice Address - Fax:720-493-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2291111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty