Individual
PHYLLIS A PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1338 PHAY AVE, CANON CITY, CO 81212-2311
(719) 285-2700
(719) 285-2975
Mailing address
825 W 6TH ST, LEADVILLE, CO 80461-2205
(719) 486-1264
(719) 486-1286
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0052834
CO
207R00000X
Internal Medicine Physician
DR.0052834
CO
Other
Enumeration date
03/30/2011
Last updated
01/07/2024
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