Healthcare Provider Details

I. General information

NPI: 1861107914
Provider Name (Legal Business Name): PFISTER FUNCTIONAL MEDICINE & CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5155 BUEHLER'S DRIVE STE 103
MEDINA OH
44256-2662
US

IV. Provider business mailing address

5155 BUEHLERS DR STE 103
MEDINA OH
44256-5389
US

V. Phone/Fax

Practice location:
  • Phone: 330-725-5277
  • Fax: 330-725-4241
Mailing address:
  • Phone: 330-725-5277
  • Fax: 330-725-4241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY JAMES PFISTER
Title or Position: AUTHORIZED OFFICIAL
Credential: FNP
Phone: 330-725-5277