Healthcare Provider Details

I. General information

NPI: 1174552087
Provider Name (Legal Business Name): CHARLES STEVEN PIGNATARO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 09/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9801 M 89
RICHLAND MI
49083-8216
US

IV. Provider business mailing address

9801 M 89
RICHLAND MI
49083-8216
US

V. Phone/Fax

Practice location:
  • Phone: 269-339-0889
  • Fax: 269-629-0456
Mailing address:
  • Phone: 269-339-0889
  • Fax: 269-629-0456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301008437
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: