Blake Robert Pennock II, DC

Chiropractor · Flagstaff, AZ

Individual Active NPI

NPI number 1053877159

Practice location

1501 S Yale St Ste 250
Flagstaff, AZ 86001-7336
Phone
(928) 557-0707

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NPI record

NPI
1053877159
Entity type
Individual (Type 1)
Enumeration date
February 13, 2019
Last updated
February 22, 2019
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Chiropractor Primary 111N00000X 8787 AZ
Student in an Organized Health Care Education/Training Program 390200000X — —

Mailing address

505 W Baseline Rd Apt 2142
Tempe, AZ 85283-5319
Phone
(563) 249-7446

About Dr. Pennock

Blake Robert Pennock II, DC is a healthcare provider registered in the NPI registry with the primary taxonomy Chiropractor (code 111N00000X). The practice location is 1501 S Yale St Ste 250, Flagstaff, AZ 86001-7336. The NPI number 1053877159 was assigned on February 13, 2019 and the record was last updated on February 22, 2019.

Dr. Pennock lists a license in the registry: #8787 (AZ) for Chiropractor. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Blake Robert Pennock II, DC?

The NPI number is 1053877159.

What is the phone number of Dr. Pennock?

The phone number listed for the practice location is (928) 557-0707.

Where is Dr. Pennock located?

1501 S Yale St Ste 250, Flagstaff, AZ 86001-7336.

What is the taxonomy code for Dr. Pennock?

The primary taxonomy code is 111N00000X – Chiropractor; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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