Provider Demographics
NPI:1306382130
Name:ALIGN THE SPINE CHIROPRACTIC
Entity type:Organization
Organization Name:ALIGN THE SPINE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNALIESE
Authorized Official - Middle Name:
Authorized Official - Last Name:DENNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-769-4380
Mailing Address - Street 1:1503B ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32951-2326
Mailing Address - Country:US
Mailing Address - Phone:941-769-4380
Mailing Address - Fax:
Practice Address - Street 1:1360 S PATRICK DR
Practice Address - Street 2:SUITE 7
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4316
Practice Address - Country:US
Practice Address - Phone:941-769-4380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty