Provider Demographics
NPI:1053453787
Name:PINNACLE ORTHOPAEDICS AND SPORTS MEDICINE
Entity Type:Organization
Organization Name:PINNACLE ORTHOPAEDICS AND SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERHARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-842-5425
Mailing Address - Street 1:300 TOWER RD NE STE 101
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-9403
Mailing Address - Country:US
Mailing Address - Phone:770-218-0219
Mailing Address - Fax:770-218-9847
Practice Address - Street 1:100 PROFESSIONAL PL STE 204
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3802
Practice Address - Country:US
Practice Address - Phone:770-834-3351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty