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General NPI Number Information
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NPI Number | 1740203561
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Entity Type | Individual
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Provider Name | JOHN A PIENKOS CH
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 02/21/2008
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Provider Practice Location Address
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Address Line | 205 HWY 17 NORTH STE A
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City | NORTH MYRTLE BEACH
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State | SC
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Zip | 29582-8943
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Country | US
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Telephone | 843-280-7533
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Fax | 843-357-1471
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Provider Business Mailing Address
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Address Line | 235 SINGLETON RIDGE RD
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City | CONWAY
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State | SC
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Zip | 29526-9136
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Country | US
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Telephone | 843-357-1444
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Fax | 843-357-1471
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 2453
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License Number State | SC
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