Provider Demographics
NPI:1821494113
Name:PINNACLE POINT CLINIC OF CHIROPRACTIC
Entity Type:Organization
Organization Name:PINNACLE POINT CLINIC OF CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:601-270-5163
Mailing Address - Street 1:2304 BARDIN RD
Mailing Address - Street 2:201
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-3850
Mailing Address - Country:US
Mailing Address - Phone:817-789-4225
Mailing Address - Fax:817-840-6407
Practice Address - Street 1:2304 BARDIN RD
Practice Address - Street 2:201
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3850
Practice Address - Country:US
Practice Address - Phone:817-789-4225
Practice Address - Fax:817-840-6407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-13
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12220111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty