Provider Demographics
NPI:1790920064
Name:PINNACLE CHIROPRACTIC HEALTH AND WELLNESS CENTER OF BRIMFIELD, LLC
Entity Type:Organization
Organization Name:PINNACLE CHIROPRACTIC HEALTH AND WELLNESS CENTER OF BRIMFIELD, LLC
Other - Org Name:PINNACLE CHIROPRACTIC HEALTH & WELLNESS CENTER OF BRIMFIELD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-618-9152
Mailing Address - Street 1:4494 STATE ROUTE 43
Mailing Address - Street 2:F1
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-8206
Mailing Address - Country:US
Mailing Address - Phone:330-678-2225
Mailing Address - Fax:330-673-2263
Practice Address - Street 1:4494 STATE ROUTE 43
Practice Address - Street 2:F1
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-8206
Practice Address - Country:US
Practice Address - Phone:330-678-2225
Practice Address - Fax:330-673-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3404111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHBA4118411Medicare PIN