Provider Demographics
NPI:1861737835
Name:PESTLE CHIROPRACTIC & SPORTS PERFORMANCE
Entity type:Organization
Organization Name:PESTLE CHIROPRACTIC & SPORTS PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PESTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:765-838-3503
Mailing Address - Street 1:2550 ELMWOOD AVE.
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-2351
Mailing Address - Country:US
Mailing Address - Phone:765-838-3503
Mailing Address - Fax:765-838-1613
Practice Address - Street 1:2550 ELMWOOD AVE.
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2351
Practice Address - Country:US
Practice Address - Phone:765-838-3503
Practice Address - Fax:765-838-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty