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General NPI Number Information
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NPI Number | 1447643697
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Entity Type | Organization
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Legal Business Name | PINNACLE CHIROPRACTIC AND PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 05/13/2015
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Provider Practice Location Address
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Address Line | 9315 COLUMBIA RD SW
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City | ETNA
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State | OH
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Zip | 43062-7126
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Country | US
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Telephone | 740-963-3900
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Fax | 740-963-3999
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Provider Business Mailing Address
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Address Line | 9315 COLUMBIA RD SW
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City | ETNA
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State | OH
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Zip | 43062-7126
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Country | US
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Telephone | 740-963-3900
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Fax | 740-963-3999
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Authorized Official
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Title or Position | DOCTOR
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Name | AMANDA STEVENSON
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Credential | DC
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Telephone | 740-966-0068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 33.021808 E-G
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3618
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License Number State | OH
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