Provider Demographics
NPI:1861107914
Name:PFISTER FUNCTIONAL MEDICINE & CHIROPRACTIC LLC
Entity type:Organization
Organization Name:PFISTER FUNCTIONAL MEDICINE & CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:PFISTER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:330-725-5277
Mailing Address - Street 1:708 E SMITH RD
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-2662
Mailing Address - Country:US
Mailing Address - Phone:330-725-5277
Mailing Address - Fax:330-725-4241
Practice Address - Street 1:708 E SMITH RD
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-2662
Practice Address - Country:US
Practice Address - Phone:330-725-5277
Practice Address - Fax:330-725-4241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty