Provider Demographics
NPI:1962171819
Name:PINNACLE CHIROPRACTIC AND REHAB PLLC
Entity type:Organization
Organization Name:PINNACLE CHIROPRACTIC AND REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:701-290-9494
Mailing Address - Street 1:3259 OAK RIDGE LOOP E
Mailing Address - Street 2:
Mailing Address - City:WEST FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58078-8482
Mailing Address - Country:US
Mailing Address - Phone:701-532-1699
Mailing Address - Fax:701-532-0815
Practice Address - Street 1:3259 OAK RIDGE LOOP E
Practice Address - Street 2:
Practice Address - City:WEST FARGO
Practice Address - State:ND
Practice Address - Zip Code:58078-8482
Practice Address - Country:US
Practice Address - Phone:701-532-1699
Practice Address - Fax:701-532-0815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty