Provider Demographics
NPI:1750583365
Name:PINNACLE HEALTH GROUP
Entity type:Organization
Organization Name:PINNACLE HEALTH GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ENID
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUISE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-577-1800
Mailing Address - Street 1:9470 ANNAPOLIS RD STE 404
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3022
Mailing Address - Country:US
Mailing Address - Phone:307-577-1800
Mailing Address - Fax:
Practice Address - Street 1:9470 ANNAPOLIS RD STE 404
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3022
Practice Address - Country:US
Practice Address - Phone:307-577-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1589PT111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty