Individual
BLAKE PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2548 LEMAY FERRY RD, SAINT LOUIS, MO 63125-3131
(314) 416-1415
(314) 416-1495
Mailing address
2548 LEMAY FERRY RD, SAINT LOUIS, MO 63125-3131
(314) 416-1415
(314) 416-1495
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
2015031321
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015031321
STATE OF MISSOURI HEARING AID DISPENSER PERMIT
MO
Enumeration date
09/29/2015
Last updated
09/29/2015
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