Provider Demographics
NPI:1689018236
Name:ALIGN YOUR SPINE CHIROPRACTIC
Entity Type:Organization
Organization Name:ALIGN YOUR SPINE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAYNA
Authorized Official - Middle Name:KRYSTIN
Authorized Official - Last Name:SOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-732-8148
Mailing Address - Street 1:859 E MAIN ST STE 7A
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-2570
Mailing Address - Country:US
Mailing Address - Phone:502-352-2940
Mailing Address - Fax:
Practice Address - Street 1:859 E MAIN ST STE 7A
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-2570
Practice Address - Country:US
Practice Address - Phone:502-352-2940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-25
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100214950Medicaid
KY7100214950Medicaid