4.10.5.1Vertical

Chiropractic & Integrated Health Centers

Multi-disciplinary clinics combining chiropractic with PT, acupuncture, and wellness services.

Market snapshot

These figures describe Chiropractic Practices (4.10.5), the segment that Chiropractic & Integrated Health Centers sits within. They are not figures for Chiropractic & Integrated Health Centers on its own.

Market size
~$16B
Growth
~3.4%CAGR (2017–22, nominal)
Companies
~39,298 firms
Firms by employee count

98.8% of firms have fewer than 20 employees: 38,838 micro-businesses, below most mandates.

The investable universe460 firms with 20+ employees
20–99
42492%
100–499
255%
500+
112%

~39,300 firms but a solo-practitioner business: 99% under 20 staff, ~4 employees each, ~$400k revenue per firm. Largely cash-pay and cash-flow-steady (~3.4%/yr), but the thin strategic-buyer pool (only 11 firms over 500 employees) means exits skew franchise- or DSO-style and sponsor-to-sponsor rather than strategic.

NAICS 621310. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Business model & economics

Revenue model

Cash-pay and insurance-reimbursed visits; memberships

Key economics

Revenue per firm
$404,184
Revenue per employee
$106,825
Employees per firm
3.8
Recurring revenue
Moderate–High

recurring and membership visits

EBITDA margin
15–25%
Capex intensity
Low

Characteristics

  • Balanced cost base: payroll is 35% of revenue, leaving room to scale margin without cutting staff
  • Thin strategic-buyer pool: only 11 firms exceed 500 employees, so exits skew sponsor-to-sponsor
  • Largely cash-pay musculoskeletal and wellness care.
  • Franchise and membership models scaling.
  • Highly fragmented independent-practice base.

NAICS 621310. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Geographic concentration

AlabamaAlaskaArizonaColoradoFloridaGeorgiaIndianaKansasMaineMassachusettsNew JerseyNorth CarolinaOklahomaPennsylvaniaTexasWyomingConnecticutMissouriWest VirginiaIllinoisNew MexicoArkansasCaliforniaDelawareDistrict of ColumbiaHawaiiKentuckyMarylandMichiganMississippiMontanaNew HampshireNew YorkOhioOregonTennesseeUtahVirginiaWashingtonWisconsinNebraskaSouth CarolinaIdahoNevadaVermontLouisianaRhode IslandMinnesotaNorth DakotaSouth DakotaIowa

Chiropractic practices are strongly over-represented in the Upper Midwest states of Iowa, North Dakota, South Dakota, and Minnesota, the profession's historical heartland (its founding college is in Davenport, Iowa).

IowaNorth DakotaSouth DakotaMinnesota

U.S. Census Bureau, 2022 Statistics of U.S. Businesses (firms by state), NAICS 621310. Concentration shown by location quotient.

M&A deal context

Deal activityModerate

Who’s acquiring

  • Chiropractic franchise networks
  • PE-backed integrated-care platforms
  • Practice consolidators

What’s driving deals

  • Franchise and membership-model expansion.
  • Conservative musculoskeletal-care demand.
  • Roll-up of fragmented practices.

Find Chiropractic & Integrated Health Centers acquisition targets

Search Acquisera’s index for companies classified under Chiropractic & Integrated Health Centers (4.10.5.1) and build a targeted deal pipeline.

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