Provider Demographics
NPI:1861553786
Name:PINTI FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:PINTI FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PINTI
Authorized Official - Suffix:I
Authorized Official - Credentials:DC
Authorized Official - Phone:304-623-5551
Mailing Address - Street 1:135 CIMARRON RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-4374
Mailing Address - Country:US
Mailing Address - Phone:304-623-5551
Mailing Address - Fax:304-623-5552
Practice Address - Street 1:135 CIMARRON RD
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-4374
Practice Address - Country:US
Practice Address - Phone:304-623-5551
Practice Address - Fax:304-623-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVWV654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0132236000Medicaid
WV0132236000Medicaid
WVU65305Medicare UPIN