Provider Demographics
NPI:1780905232
Name:PYNKERTON CHIROPRACTIC GROUP, PC
Entity type:Organization
Organization Name:PYNKERTON CHIROPRACTIC GROUP, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PYNKERTON
Authorized Official - Middle Name:DION
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:317-257-7463
Mailing Address - Street 1:2102 E 52ND ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-1496
Mailing Address - Country:US
Mailing Address - Phone:317-257-7463
Mailing Address - Fax:317-255-0758
Practice Address - Street 1:2102 E 52ND ST
Practice Address - Street 2:SUITE E
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1496
Practice Address - Country:US
Practice Address - Phone:317-257-7463
Practice Address - Fax:317-255-0758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty