Provider Demographics
NPI:1508299462
Name:ALIGN CHIROPRACTIC HENDERSON LLC
Entity Type:Organization
Organization Name:ALIGN CHIROPRACTIC HENDERSON LLC
Other - Org Name:ST. ROSE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KISSLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-335-1709
Mailing Address - Street 1:9975 S EASTERN AVE
Mailing Address - Street 2:SUITE 105A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-7949
Mailing Address - Country:US
Mailing Address - Phone:702-293-9100
Mailing Address - Fax:702-293-9102
Practice Address - Street 1:9975 S EASTERN AVE
Practice Address - Street 2:SUITE 105A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-7949
Practice Address - Country:US
Practice Address - Phone:702-293-9100
Practice Address - Fax:702-293-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB01327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty