Provider Demographics
NPI:1073985552
Name:ALIGN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ALIGN CHIROPRACTIC LLC
Other - Org Name:ALIGN CHIROPRACTIC AND MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:TUDOR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:541-295-9014
Mailing Address - Street 1:2522 CURLEW CIR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-1653
Mailing Address - Country:US
Mailing Address - Phone:907-306-0585
Mailing Address - Fax:
Practice Address - Street 1:2665 E. TUDOR RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503
Practice Address - Country:US
Practice Address - Phone:907-306-0585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty