Provider Demographics
NPI:1154909794
Name:PERFECTLY ALIGNED CHIROPRACTIC, A NISSENBAUM PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:PERFECTLY ALIGNED CHIROPRACTIC, A NISSENBAUM PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:NISSENBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:650-226-8348
Mailing Address - Street 1:1100 LAUREL ST STE D
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-5000
Mailing Address - Country:US
Mailing Address - Phone:650-226-8348
Mailing Address - Fax:650-666-6747
Practice Address - Street 1:1100 LAUREL ST STE D
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-5000
Practice Address - Country:US
Practice Address - Phone:650-226-8348
Practice Address - Fax:650-666-6747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty