Provider Demographics
NPI:1659053395
Name:PINNACLE HEALTH PLLC
Entity Type:Organization
Organization Name:PINNACLE HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:DEMERE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:760-522-1985
Mailing Address - Street 1:1829 S GOLDSMITH AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83642-6699
Mailing Address - Country:US
Mailing Address - Phone:760-522-1985
Mailing Address - Fax:
Practice Address - Street 1:1829 S GOLDSMITH AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642-6699
Practice Address - Country:US
Practice Address - Phone:760-522-1985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy