Pennington, Lori Mandy

Pennington, Lori Mandy is an individual health care provider with primary practice located at 6315 North Center Dr Bldg 20 Suite 230, Norfolk VA 23502-3931. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Pennington, Lori Mandy can be contacted via phone (757) 461-7974.

Contact Information

Primary practice address
6315 North Center Dr Bldg 20 Suite 230 Norfolk VA 23502-3931
Fax: (757) 461-4829
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0618001488 Virginia

Profile Details

NPI number 1295723526
LBN Legal business name Pennington, Lori Mandy
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated May 13th, 2008 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295723526 NPPES
Virginia MEDICAID 010198453

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