Provider Demographics
NPI:1366865263
Name:ALIGN CHIROPRACTIC CLINIC LLC
Entity Type:Organization
Organization Name:ALIGN CHIROPRACTIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:870-489-5159
Mailing Address - Street 1:1002 DIAMOND RDG
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65109-6896
Mailing Address - Country:US
Mailing Address - Phone:573-635-4827
Mailing Address - Fax:573-635-4361
Practice Address - Street 1:1002 DIAMOND RDG
Practice Address - Street 2:SUITE 200
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-6896
Practice Address - Country:US
Practice Address - Phone:573-635-4827
Practice Address - Fax:573-635-4361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center