Provider Demographics
NPI:1578382610
Name:ALIGN CHIROPRACTIC CLINIC LOZ LLC
Entity type:Organization
Organization Name:ALIGN CHIROPRACTIC CLINIC LOZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:573-635-4827
Mailing Address - Street 1:2352 STATE ROAD Y
Mailing Address - Street 2:
Mailing Address - City:NEW BLOOMFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65063-1172
Mailing Address - Country:US
Mailing Address - Phone:573-635-4827
Mailing Address - Fax:
Practice Address - Street 1:5727 CHAPEL DR STE 3
Practice Address - Street 2:
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-3049
Practice Address - Country:US
Practice Address - Phone:573-635-4827
Practice Address - Fax:573-635-4361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty