Provider Demographics
NPI:1649596339
Name:ALIGN CHIROMEDICAL MPLS PA
Entity type:Organization
Organization Name:ALIGN CHIROMEDICAL MPLS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-868-6894
Mailing Address - Street 1:2025 NICOLLET AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2552
Mailing Address - Country:US
Mailing Address - Phone:612-871-1100
Mailing Address - Fax:612-874-6141
Practice Address - Street 1:2025 NICOLLET AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2552
Practice Address - Country:US
Practice Address - Phone:612-871-1100
Practice Address - Fax:612-874-6141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-20
Last Update Date:2010-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty