Provider Demographics
NPI:1639550791
Name:ALIGN CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:ALIGN CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:WELLS
Authorized Official - Last Name:WILLEMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:248-601-6100
Mailing Address - Street 1:530 PINE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1482
Mailing Address - Country:US
Mailing Address - Phone:248-601-6100
Mailing Address - Fax:248-601-9574
Practice Address - Street 1:530 PINE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1482
Practice Address - Country:US
Practice Address - Phone:248-601-6100
Practice Address - Fax:248-601-9574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009788111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMI4878Medicare PIN