Blake Robert Pennock Ii (NPI# 1053877159, PAC ID# 1850632969) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CHIROPRACTIC.
Nation Provider ID (NPI) | 1053877159 |
PAC ID by PECOS | 1850632969 |
Professional Enrollment ID | I20190417001928 |
Full Name | Blake Robert Pennock Ii |
Organization Legal Name | MUNDERLOH MEDICAL LLC |
Address |
1501 S Yale St Suite 250 Flagstaff AZ 86001-7336 |
Phone Number | 9285560707 |
Gender | M |
Medical School | PALMER COLLEGE CHIROPRACTIC - DAVENPORT |
Graduation Year | 2018 |
Primary Specialty | CHIROPRACTIC |
Group Practice PAC ID | 8820381957 |
Number of Group Practice Members | 3 |
Accepts Medicare Assignment | Y |
Address | Phone | Organization |
---|---|---|
1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7336 | 9285560707 | MUNDERLOH MEDICAL LLC |
Organization Legal Name | MUNDERLOH MEDICAL LLC |
Physicians | 3 |
Name | Specialty | Organization | Address |
---|---|---|---|
Timothy James Munderloh | Chiropractic | Munderloh Medical LLC | 1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7336 |
Travis C Stiegler | General Practice | Munderloh Medical LLC | 1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7336 |
Street Address |
1501 S YALE ST SUITE 250 |
City | FLAGSTAFF |
State | AZ |
Zip | 86001-7336 |
Name | Specialty | Organization | Address |
---|---|---|---|
Timothy James Munderloh | Chiropractic | Munderloh Medical LLC | 1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7336 |
Theresa Salvatore | Nurse Practitioner | North Country Healthcare Inc | 1501 S Yale St, Suite 252, Flagstaff, AZ 86001-7336 |
Bridget Wicks | Nurse Practitioner | North Country Healthcare Inc | 1501 S Yale St, Suite 252, Flagstaff, AZ 86001-7336 |
Travis C Stiegler | General Practice | Munderloh Medical LLC | 1501 S Yale St, Suite 250, Flagstaff, AZ 86001-7336 |
Brandon Abbott | Internal Medicine | North Country Healthcare Inc | 1501 S Yale St, Suite 252, Flagstaff, AZ 86001-7336 |
Norina Witt | Pediatric Medicine | North Country Healthcare Inc | 1501 S Yale St, Suite 252, Flagstaff, AZ 86001-7336 |
Jessie Thibedeau | Certified Nurse Midwife (cnm) | North Country Healthcare Inc | 1501 S Yale St, Suite 252, Flagstaff, AZ 86001-7336 |
Name | Specialty | Organization | Address |
---|---|---|---|
Heather K Boyle | Psychiatry | 1515 N San Francisco, Flagstaff, AZ 86001 | |
Carrie J Monroy | Family Medicine | Arizona Independent Medical Associates, Pllc | 3150 N Winding Brook Rd, Flagstaff, AZ 86001-0972 |
Christine M Mcgregor | Nurse Practitioner | Arizona Independent Medical Associates, Pllc | 3150 N Winding Brook Rd, Flagstaff, AZ 86001-0972 |
Terry Smith | Nurse Practitioner | Arizona Independent Medical Associates, Pllc | 3150 N Winding Brook Rd, Flagstaff, AZ 86001-0972 |
Stephan Stellmacher | Internal Medicine | Arizona Independent Medical Associates, Pllc | 3150 N Winding Brook Rd, Flagstaff, AZ 86001-0972 |
Jessica K Newton | Physician Assistant | Arizona Independent Medical Associates, Pllc | 3150 N Winding Brook Rd, Flagstaff, AZ 86001-0972 |
Katherine E Sherman | Nurse Practitioner | Arizona Independent Medical Associates, Pllc | 3150 N Winding Brook Rd, Flagstaff, AZ 86001-0972 |
Rebecca Le Roy | Nurse Practitioner | Arizona Independent Medical Associates, Pllc | 3150 N Winding Brook Rd, Flagstaff, AZ 86001-0972 |
Ari D Plosker | Diagnostic Radiology | Steward Medical Group Inc | 2520 N Eddy Dr, Flagstaff, AZ 86001-1000 |
Teresa A Dunn | Clinical Social Worker | 21 W Pine Ave, Flagstaff, AZ 86001-1338 | |
Find all physicians in zip 86001 |
City | FLAGSTAFF |
Zip Code | 86001 |
Specialty | CHIROPRACTIC |
City + Specialty | FLAGSTAFF + CHIROPRACTIC |
Please comment or provide details below to improve the information on Blake Robert Pennock Ii.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.