Provider Demographics
NPI:1255619169
Name:ALIGN CHIROPRACTIC LLC.
Entity type:Organization
Organization Name:ALIGN CHIROPRACTIC LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:DC,BS,BA
Authorized Official - Phone:612-308-2974
Mailing Address - Street 1:3158 VIKING BLVD NW
Mailing Address - Street 2:
Mailing Address - City:CEDAR
Mailing Address - State:MN
Mailing Address - Zip Code:55011-9339
Mailing Address - Country:US
Mailing Address - Phone:763-753-0993
Mailing Address - Fax:
Practice Address - Street 1:3158 VIKING BLVD NW
Practice Address - Street 2:
Practice Address - City:CEDAR
Practice Address - State:MN
Practice Address - Zip Code:55011-9339
Practice Address - Country:US
Practice Address - Phone:763-753-0993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2017-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty