=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497501977
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALIGN STUDIO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2024
-----------------------------------------------------
Last Update Date | 04/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 87-2070 FARRINGTON HWY # B4
-----------------------------------------------------
City | WAIANAE
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96792-3757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-206-6769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 87-2070 FARRINGTON HWY # B4
-----------------------------------------------------
City | WAIANAE
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96792-3757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-206-6769
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-FOUNDER
-----------------------------------------------------
Name | NATHANIEL DAVIS
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 808-206-6769
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------