Healthcare Provider Details

I. General information

NPI: 1386766764
Provider Name (Legal Business Name): DENNING HEALTHMALL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 ALTER ST
HAZLETON PA
18201-5062
US

IV. Provider business mailing address

555 ALTER ST
HAZLETON PA
18201-5062
US

V. Phone/Fax

Practice location:
  • Phone: 570-450-6824
  • Fax: 570-450-6020
Mailing address:
  • Phone: 570-450-6824
  • Fax: 570-450-6020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC004028-L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1437574
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BLUE SHIELD

VIII. Authorized Official

Name: DR. WILLIAM CARL DENNING
Title or Position: PRESIDENT
Credential: D.C.
Phone: 570-450-6824