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General NPI Number Information
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NPI Number | 1487960035
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Entity Type | Organization
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Legal Business Name | ALIGN HEALTHCARE LLC
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Dates
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Enumeration Date | 08/20/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 1245 EAST WALNUT ST
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City | CARBONDALE
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State | IL
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Zip | 62901
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Country | US
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Telephone | 618-519-9334
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Fax | 618-549-2694
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Provider Business Mailing Address
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Address Line | PO BOX 3965
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City | CARBONDALE
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State | IL
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Zip | 62902-3965
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Country | US
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Telephone | 618-519-9334
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Fax | 618-549-2694
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Authorized Official
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Title or Position | CEO
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Name | DR. RYAN D HESS
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Credential | DC
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Telephone | 618-519-9334
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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 | 038010453
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License Number State | IL
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