Provider Demographics
NPI:1225765811
Name:PINNACLE CHIROPRACTIC & WELLNESS PLLC
Entity Type:Organization
Organization Name:PINNACLE CHIROPRACTIC & WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:D'JUAN
Authorized Official - Middle Name:AMAUD
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-260-8188
Mailing Address - Street 1:204 FAIR OAKS LN
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27127-3178
Mailing Address - Country:US
Mailing Address - Phone:336-248-8402
Mailing Address - Fax:336-893-9511
Practice Address - Street 1:204 FAIR OAKS LN
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27127-3178
Practice Address - Country:US
Practice Address - Phone:336-248-8402
Practice Address - Fax:336-893-9511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty