Provider Demographics
NPI:1386862340
Name:ALIGN CHIROPRACTIC CLINIC & ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ALIGN CHIROPRACTIC CLINIC & ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE SOUSA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-532-2273
Mailing Address - Street 1:4327 MUNDY MILL RD
Mailing Address - Street 2:SUITE A - BLDG. ONE
Mailing Address - City:OAKWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30566-2563
Mailing Address - Country:US
Mailing Address - Phone:770-532-2273
Mailing Address - Fax:770-532-5988
Practice Address - Street 1:4327 MUNDY MILL RD
Practice Address - Street 2:SUITE A - BLDG. ONE
Practice Address - City:OAKWOOD
Practice Address - State:GA
Practice Address - Zip Code:30566-2563
Practice Address - Country:US
Practice Address - Phone:770-532-2273
Practice Address - Fax:770-532-5988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007124261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA007124OtherCHIR