Provider Demographics
NPI:1275263535
Name:SPINE ALIGN CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:SPINE ALIGN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WINTER
Authorized Official - Middle Name:CALVERT
Authorized Official - Last Name:CULLEN
Authorized Official - Suffix:V
Authorized Official - Credentials:DC
Authorized Official - Phone:561-236-7103
Mailing Address - Street 1:7177 NOLENSVILLE RD STE A2
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-9597
Mailing Address - Country:US
Mailing Address - Phone:615-776-2424
Mailing Address - Fax:
Practice Address - Street 1:7177 NOLENSVILLE RD STE A2
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-9597
Practice Address - Country:US
Practice Address - Phone:615-776-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty