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General NPI Number Information
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NPI Number | 1932431988
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Entity Type | Individual
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Provider Name | MARK ALLEN PENNINGTON LMT
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Gender | Male
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Dates
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Enumeration Date | 02/02/2010
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 2670 N COLUMBUS ST SUITE J
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City | LANCASTER
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State | OH
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Zip | 43130-8408
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Country | US
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Telephone | 740-687-4917
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Fax | 740-205-8073
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Provider Business Mailing Address
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Address Line | 2670 N COLUMBUS ST SUITE J
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City | LANCASTER
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State | OH
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Zip | 43130-8408
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Country | US
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Telephone | 740-687-4917
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Fax | 740-205-8073
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 13553
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License Number State | OH
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