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Dr. Blake Robert Pennock II, DC
Chiropractor in Flagstaff, Arizona
NPI 1053877159

Blake Robert Pennock II is a Chiropractor based in Tempe, AZ. Blake Robert Pennock II practices in Flagstaff, AZ and has the professional credentials of DC. The NPI Number for Blake Robert Pennock II is 1053877159 and holds a License No. (Arizona).

The current practice location address for Blake Robert Pennock II is 1501 S Yale St Ste 250, Flagstaff, AZ and can be reached out via phone at 928-557-0707.

Location: 1501 S Yale St Ste 250, Flagstaff, AZ, 85283-5319
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053877159
Provider Name
Blake Robert Pennock II
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
1501 S Yale St Ste 250, Flagstaff, AZ, 85283-5319
Phone Number
928-557-0707
Fax Number
Provider Enumeration Date
02/13/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1501 S Yale St Ste 250
City
Flagstaff
State
Arizona
Zip
86001-7336
Phone Number
928-557-0707
Fax Number
person
Provider Business Mailing Address Details
Address
1501 S Yale St Ste 250
City
Flagstaff
State
Arizona
Zip
86001-7336
Phone Number
928-557-0707
Fax Number
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
8787 (Arizona)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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