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General NPI Number Information
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NPI Number | 1255619169
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Entity Type | Organization
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Legal Business Name | ALIGN CHIROPRACTIC LLC.
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Dates
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Enumeration Date | 07/26/2011
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 3158 VIKING BLVD NW
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City | CEDAR
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State | MN
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Zip | 55011-9339
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Country | US
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Telephone | 763-753-0993
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Fax |
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Provider Business Mailing Address
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Address Line | 3158 VIKING BLVD NW
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City | CEDAR
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State | MN
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Zip | 55011-9339
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Country | US
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Telephone | 763-753-0993
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ERIC JAMES DANIELS
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Credential | D.C.,B.S.,B.A.
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Telephone | 612-308-2974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5335
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License Number State | MN
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