Provider Demographics
NPI:1134371941
Name:PINTO, PETER JOHN (DC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:JOHN
Last Name:PINTO
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 1:13203 S 48TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-5007
Mailing Address - Country:US
Mailing Address - Phone:480-496-4949
Mailing Address - Fax:
Practice Address - Street 1:13203 S 48TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5007
Practice Address - Country:US
Practice Address - Phone:480-496-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-13
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor