Provider Demographics
NPI:1073958542
Name:PINNACLE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:PINNACLE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KALI
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-334-5984
Mailing Address - Street 1:211 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3013
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3013
Practice Address - Country:US
Practice Address - Phone:412-334-5984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty