Provider Demographics
NPI:1952582421
Name:ALIGN SPINE HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:ALIGN SPINE HEALTH CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KINDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:INGRAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-562-0390
Mailing Address - Street 1:8555 16TH ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2816
Mailing Address - Country:US
Mailing Address - Phone:301-562-0390
Mailing Address - Fax:301-562-0392
Practice Address - Street 1:8555 16TH ST
Practice Address - Street 2:SUITE 800
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2816
Practice Address - Country:US
Practice Address - Phone:301-562-0390
Practice Address - Fax:301-562-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03394111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDV05651OtherUPIN
MDV05651OtherUPIN