Organization
ALIGN SPINE AND SPORTS REHAB, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PORCHA ANDERSON DC (CLINICAL DIRECTOR)
(469) 346-8573
Entity
Organization
Contact information
Practice address
700 MIRKES PKWY, DESOTO, TX 75115-2972
(469) 346-8573
Mailing address
700 MIRKES PKWY, DESOTO, TX 75115-2972
(469) 346-8573
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
111NR0400X
Rehabilitation Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215448063
—
TX
05
—
1417463498
—
TX
Enumeration date
06/08/2021
Last updated
06/08/2021
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