Healthcare Provider Details

I. General information

NPI: 1306429295
Provider Name (Legal Business Name): PINKHAM MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2170 RIVERSIDE DR
COLUMBUS OH
43221-4076
US

IV. Provider business mailing address

2170 RIVERSIDE DR
COLUMBUS OH
43221-4076
US

V. Phone/Fax

Practice location:
  • Phone: 614-486-7525
  • Fax: 614-488-4736
Mailing address:
  • Phone: 614-486-7525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIA PINKHAM
Title or Position: OWNER/PROVIDER
Credential: DAOM
Phone: 614-486-7525