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Organization

JENNINGS ORTHOPEDIC INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HENRY ALVIN JENNINGS JR. CPO (PRESIDENT)
(951) 352-2029
Entity
Organization

Contact information

Practice address
10683 MAGNOLIA AVE, SUITE A, RIVERSIDE, CA 92505-1893
(951) 352-2029
(951) 352-2549
Mailing address
10683 MAGNOLIA AVE, SUITE A, RIVERSIDE, CA 92505-1893
(951) 352-2029
(951) 352-2549

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
CPO02544
CA
224P00000X
Prosthetist
Primary
CPO02544
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GXC000030
CA
Enumeration date
11/08/2006
Last updated
12/22/2011
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