Provider Demographics
NPI:1003868506
Name:PINNACLE MARICOPA, LLC
Entity type:Organization
Organization Name:PINNACLE MARICOPA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-899-9829
Mailing Address - Street 1:3930 S ALMA SCHOOL RD
Mailing Address - Street 2:#103
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-4497
Mailing Address - Country:US
Mailing Address - Phone:480-899-9829
Mailing Address - Fax:480-726-9829
Practice Address - Street 1:21300 N. JOHN WAYNE PARKWAY
Practice Address - Street 2:#107
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85239
Practice Address - Country:US
Practice Address - Phone:480-899-9829
Practice Address - Fax:480-726-9829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty