Provider Demographics
NPI:1154670115
Name:PINNACLE CHIROPRACTIC INC
Entity Type:Organization
Organization Name:PINNACLE CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-395-5179
Mailing Address - Street 1:2 RAVINIA DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-2104
Mailing Address - Country:US
Mailing Address - Phone:770-395-5179
Mailing Address - Fax:770-392-7303
Practice Address - Street 1:2 RAVINIA DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2104
Practice Address - Country:US
Practice Address - Phone:770-395-5179
Practice Address - Fax:770-392-7303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
202I351778OtherSOLE PROPRIETOR PTAN
GA1730111493OtherSOLE PROPRIETOR NPI