Provider Demographics
NPI:1912143330
Name:ALIGNED CLINICS OF CHIROPRACTIC
Entity Type:Organization
Organization Name:ALIGNED CLINICS OF CHIROPRACTIC
Other - Org Name:KIMBALL CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KIMBALL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:801-318-0722
Mailing Address - Street 1:340 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-2230
Mailing Address - Country:US
Mailing Address - Phone:801-492-8188
Mailing Address - Fax:801-492-3432
Practice Address - Street 1:340 W MAIN ST
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-2230
Practice Address - Country:US
Practice Address - Phone:801-492-8188
Practice Address - Fax:801-492-3432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-07
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7111227-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000066118Medicare PIN