MEDICARE: ALIGN SPINAL CARE AND FUNCTIONAL WELLNESS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1316673023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALIGN SPINAL CARE AND FUNCTIONAL WELLNESS PLLC

Provider Business Mailing Address
First Line	:	1025 COMMERCE DR STE B
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-7601
Country	:	US
Telephone Number	:	906-273-0399
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 COMMERCE DR STE B
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-7601
Country	:	US
Telephone Number	:	906-273-0399
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. LISA M FRISK
Credential	:	DC
Telephone Number	:	906-273-0399

Provider Enumeration Date	:	07/26/2022
Last Update Date	:	07/26/2022

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