Provider Demographics
NPI:1013246214
Name:PINKSTON, JON ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:ROBERT
Last Name:PINKSTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 CHESTERFIELD MALL
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4807
Mailing Address - Country:US
Mailing Address - Phone:636-346-1395
Mailing Address - Fax:
Practice Address - Street 1:91 CHESTERFIELD MALL
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4807
Practice Address - Country:US
Practice Address - Phone:636-346-1395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-17
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011001253111NI0013X
IL038.011843111NI0013X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner