Provider Demographics
NPI:1568697407
Name:PINNACLE CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:PINNACLE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:314-974-6676
Mailing Address - Street 1:P.O. BOX 119, 211 WEST HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:65264-3027
Mailing Address - Country:US
Mailing Address - Phone:314-974-6676
Mailing Address - Fax:
Practice Address - Street 1:211 W HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:MO
Practice Address - Zip Code:65264-2013
Practice Address - Country:US
Practice Address - Phone:314-974-6676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-21
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO2005000400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1376692418OtherPTAN #00025816