Blake Pennock, DC

NPI 1053877159 · on the registry since 2019 · sole proprietor

Practice

Address: 1501 S Yale St Ste 250
Flagstaff, AZ 86001
Phone: (928) 557-0707
Organisation at this address: Naz Mua Llc
Lhcg Lxxvii, Llc
Elite Uc Care Llc
Proforma Health Pllc
Munderloh Medical Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 19

Registry record

Primary taxonomy: Chiropractor
111N00000X
Also registered as: Student in an Organized Health Care Education/Training Program
Licence states on file: AZ
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2019-02-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona