Provider Demographics
NPI:1639557705
Name:ALIGN ATLANTA
Entity Type:Organization
Organization Name:ALIGN ATLANTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCQUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-548-5154
Mailing Address - Street 1:4292 MEMORIAL DR
Mailing Address - Street 2:STE B
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-1224
Mailing Address - Country:US
Mailing Address - Phone:404-548-5154
Mailing Address - Fax:404-393-3450
Practice Address - Street 1:4292 MEMORIAL DR
Practice Address - Street 2:STE B
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-1224
Practice Address - Country:US
Practice Address - Phone:404-548-5154
Practice Address - Fax:404-393-3450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008905111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty