Healthcare Provider Details

I. General information

NPI: 1982520714
Provider Name (Legal Business Name): MICHAEL LANIER PENNINGTON JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 HILLWOOD DR
AKRON OH
44320-2337
US

IV. Provider business mailing address

448 HILLWOOD DR
AKRON OH
44320-2337
US

V. Phone/Fax

Practice location:
  • Phone: 330-217-7556
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License NumberTL90628
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: