John Penley
Sports Medicine
1630 Bogie Lake Rd
White Lake
, Michigan 48383
John Penley
Sports Medicine
1630 Bogie Lake Rd
White Lake
, Michigan 48383
(734) 474-0783
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About
Features
Specialties
- Sports Medicine
Languages spoken
- English
Location
First Address
- John Penley
- Po Box 1356
- Brighton, MI
- Zip : 48116
- Phone : (734) 474-0783
Second Address
- John Penley
- 1630 Bogie Lake Rd
- White Lake, MI
- Zip : 48383
- Phone : (734) 474-0783
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2081S0010X | Sports Medicine | 2601001645 | MI |
| Y | 213ES0000X | Sports Medicine | 2601001645 | MI |
National Provider Identifier
| NPI | 1326583170 |
|---|---|
| Provider Name | John Penley |
| First Address | Brighton, MI 48116 |
| Second Address | White Lake, MI 48383 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 04/01/2017 |
| Last Update Date | 04/01/2017 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.