Provider Demographics
NPI:1275313447
Name:PINTELLO, JOHN CHARLES
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:PINTELLO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5021 RIMROCK DR
Mailing Address - Street 2:
Mailing Address - City:BAR NUNN
Mailing Address - State:WY
Mailing Address - Zip Code:82601-7704
Mailing Address - Country:US
Mailing Address - Phone:307-258-8717
Mailing Address - Fax:
Practice Address - Street 1:5021 RIMROCK DR
Practice Address - Street 2:
Practice Address - City:BAR NUNN
Practice Address - State:WY
Practice Address - Zip Code:82601-7704
Practice Address - Country:US
Practice Address - Phone:307-258-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services