Provider Demographics
NPI:1518032671
Name:PINNACLE REHABILITATION AND PERSONAL TRAINING P C
Entity Type:Organization
Organization Name:PINNACLE REHABILITATION AND PERSONAL TRAINING P C
Other - Org Name:CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:WITHERS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT CSCS CLT
Authorized Official - Phone:989-343-3000
Mailing Address - Street 1:621 COURT ST
Mailing Address - Street 2:STE 101
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-9390
Mailing Address - Country:US
Mailing Address - Phone:989-343-3000
Mailing Address - Fax:989-343-3003
Practice Address - Street 1:621 COURT ST
Practice Address - Street 2:STE 101
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-8767
Practice Address - Country:US
Practice Address - Phone:989-343-3000
Practice Address - Fax:989-343-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty