Provider Demographics
NPI:1770763005
Name:ALIGNMENT CHIROPRACTIC AND WELLNESS CLC, LLC
Entity type:Organization
Organization Name:ALIGNMENT CHIROPRACTIC AND WELLNESS CLC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:TALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:334-445-2525
Mailing Address - Street 1:1550 ANDREWS AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-3718
Mailing Address - Country:US
Mailing Address - Phone:334-445-2525
Mailing Address - Fax:334-445-1212
Practice Address - Street 1:1550 ANDREWS AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-3718
Practice Address - Country:US
Practice Address - Phone:334-445-2525
Practice Address - Fax:334-445-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-03
Last Update Date:2007-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51006839OtherBLUE CROSS BLUE SHIELD