Provider Demographics
NPI:1487775227
Name:PINAULT, JOHN RENE (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RENE
Last Name:PINAULT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GOFFSTOWN
Mailing Address - State:NH
Mailing Address - Zip Code:03045-1767
Mailing Address - Country:US
Mailing Address - Phone:603-497-3366
Mailing Address - Fax:
Practice Address - Street 1:4 MAIN ST
Practice Address - Street 2:
Practice Address - City:GOFFSTOWN
Practice Address - State:NH
Practice Address - Zip Code:03045-1767
Practice Address - Country:US
Practice Address - Phone:603-497-3366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHNH2510696111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30010868Medicaid
NH30010868Medicaid