Provider Demographics
NPI:1649437906
Name:PINNACLE CHIROPRACTIC HEALTH & WELLNESS CENTER LLC
Entity type:Organization
Organization Name:PINNACLE CHIROPRACTIC HEALTH & WELLNESS CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PARTNER
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:330-928-2273
Mailing Address - Street 1:1251 MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-4944
Mailing Address - Country:US
Mailing Address - Phone:330-928-2273
Mailing Address - Fax:330-922-4088
Practice Address - Street 1:1251 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-4944
Practice Address - Country:US
Practice Address - Phone:330-928-2273
Practice Address - Fax:330-922-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3404111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PI9338461Medicare PIN
BA4118411Medicare PIN