Healthcare Provider Details

I. General information

NPI: 1861553786
Provider Name (Legal Business Name): PINTI FAMILY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 CIMARRON RD
CLARKSBURG WV
26301-4374
US

IV. Provider business mailing address

135 CIMARRON RD
CLARKSBURG WV
26301-4374
US

V. Phone/Fax

Practice location:
  • Phone: 304-623-5551
  • Fax: 304-623-5552
Mailing address:
  • Phone: 304-623-5551
  • Fax: 304-623-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberWV654
License Number StateWV

VIII. Authorized Official

Name: DR. STEPHEN L PINTI I
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: DC
Phone: 304-623-5551