Selected for their accomplishments, experience, and consumer ratings, members of the International Association of Chiropractors are leaders in their field, and a patients first choice.

 

Enrollment into
The International Association of Chiropractors

Contact Information:
*First Name
Middle Name
*Last Name
Street Address 1
Street Address 2 (Suite Number)
City
State/Province
Zip/Postal Code
Country
* Business Phone
Cell Phone (not for publication)
Home Phone (not for publication)
Email Address
Name of Practice/ Hospital/ Agency
Years of Experience
Where Did You Attain Your Degree?
What is Your Specialization?
Affiliations or Professional Society Memberships:
More About You / Additional Comments
   
 

410 Park Avenue, 15th Floor - New York, NY 10022

Tel: 1-631-650-2499 | Fax: 1-646-349-4611