Provider Demographics
NPI:1154670115
Name:PINNACLE CHIROPRACTIC INC
Entity type:Organization
Organization Name:PINNACLE CHIROPRACTIC INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BART
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-698-0909
Mailing Address - Street 1:6111 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:E202
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328
Mailing Address - Country:US
Mailing Address - Phone:770-698-0909
Mailing Address - Fax:770-679-8090
Practice Address - Street 1:6111 PEACHTREE DUNWOODY RD
Practice Address - Street 2:E202
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328
Practice Address - Country:US
Practice Address - Phone:770-698-0909
Practice Address - Fax:770-698-0909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1730111493OtherSOLE PROPRIETOR NPI
202I351778OtherSOLE PROPRIETOR PTAN