Pennella, Marygrace
Pennella, Marygrace is an individual health care provider with primary practice located at 9780 Lantern Rd Suite 230, Fishers IN 46037-4092. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Pennella, Marygrace can be contacted via phone (317) 863-0365.Contact Information
Primary practice address
9780 Lantern Rd Suite 230
Fishers IN 46037-4092
Phone: (317) 863-0365
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | 08001966A | Indiana |
Profile Details
| NPI number | 1265551899 |
|---|---|
| LBN Legal business name | Pennella, Marygrace |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265551899 | NPPES |
| Indiana | MEDICAID | 200316610A |
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