Provider Demographics
NPI:1699244871
Name:PINNACLE INTEGRATIVE HEALTHCARE, PLLC
Entity type:Organization
Organization Name:PINNACLE INTEGRATIVE HEALTHCARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:REESE
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:PETERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-289-7171
Mailing Address - Street 1:2418 S 18TH ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-6827
Mailing Address - Country:US
Mailing Address - Phone:563-503-1466
Mailing Address - Fax:
Practice Address - Street 1:2418 S 18TH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-6827
Practice Address - Country:US
Practice Address - Phone:563-289-7171
Practice Address - Fax:563-217-1529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty