Provider Demographics
NPI:1447643697
Name:PINNACLE CHIROPRACTIC AND PHYSICAL THERAPY
Entity type:Organization
Organization Name:PINNACLE CHIROPRACTIC AND PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-966-0068
Mailing Address - Street 1:9315 COLUMBIA RD SW
Mailing Address - Street 2:
Mailing Address - City:ETNA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7126
Mailing Address - Country:US
Mailing Address - Phone:740-963-3900
Mailing Address - Fax:740-963-3999
Practice Address - Street 1:9315 COLUMBIA RD SW
Practice Address - Street 2:
Practice Address - City:ETNA
Practice Address - State:OH
Practice Address - Zip Code:43062-7126
Practice Address - Country:US
Practice Address - Phone:740-963-3900
Practice Address - Fax:740-963-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-12
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3618111N00000X
OH33.021808 E-G225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty