Provider Demographics
NPI:1992400634
Name:PENNING CHIROPRACTIC LLC.
Entity type:Organization
Organization Name:PENNING CHIROPRACTIC LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:PENNING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-540-8457
Mailing Address - Street 1:6900 UNIVERSITY AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6900 UNIVERSITY AVE STE 108
Practice Address - Street 2:
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1505
Practice Address - Country:US
Practice Address - Phone:515-274-6104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty