Provider Demographics
NPI:1235285784
Name:PINNACLE CARE GROUP
Entity Type:Organization
Organization Name:PINNACLE CARE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:K
Authorized Official - Last Name:GEBHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-645-9595
Mailing Address - Street 1:415 E CROSSVILLE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-3037
Mailing Address - Country:US
Mailing Address - Phone:770-645-9595
Mailing Address - Fax:770-645-9522
Practice Address - Street 1:415 E CROSSVILLE RD
Practice Address - Street 2:SUITE B
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3037
Practice Address - Country:US
Practice Address - Phone:770-645-9595
Practice Address - Fax:770-645-9522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10958111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID