Chiropractic Degree and Career Guide
Getting Licensed as a Chiropractor
You’ve completed your educational requirements—now find out the next steps toward becoming a licensed chiropractor.
If you can’t drive a car, fly a plane, or even go fishing without a license, you certainly would want chiropractors to be licensed! Getting licensed is the final step that allows you to practice chiropractic.
In This Article
The general public has become more confident in chiropractic for many reasons. In part, clients often gain relief from sudden and long-term issues alike. For example, more than three-quarters of people who sought care for back pain called chiropractic treatment “very effective,” according to a survey of more than 7,600 adults.
People are also confident in chiropractic because all practitioners must be licensed.
In addition to the required coursework to become a Doctor of Chiropractic (DC), chiropractors in all 50 states plus Washington, D.C., Puerto Rico, and the Virgin Islands must be licensed. This step is more than simply a bureaucratic formality. The field pushed for licensure through the 20th century in part to show skeptics that chiropractic is a serious, effective, and safe medical practice.
Like aspiring lawyers, chiropractors must pass an exam administered by the state in which they will practice.
Just as aspiring lawyers must pass the state bar exams, so too must chiropractors pass an exam administered by the state in which they intend to practice.
The scope of work — in other words, what chiropractors are allowed to do — varies from state to state, too. Some areas limit chiropractic work to manual adjustment only; others allow additional services, from trigger point therapy to nutritional counseling.
National and State Licenses
To earn a license to practice chiropractic, you need to take and pass the National Board of Chiropractic Examiners (NBCE) exam. This exam is actually a series of tests taken at different times during your studies in an accredited DC program.
All but five states require additional, state-specific qualifications, such as exams or interviews with state licensing boards. (Colorado, Kentucky, New York, Rhode Island, and Virginia require only passage of the national exam.) States grant these licenses when chiropractors pass a test about location-specific regulations and laws. State regulatory boards, which work with the NBCE, oversee the requirements—including passing the state exam—to legally practice.
Some states have reciprocity with other states. That means that if you are licensed in one state, you may be able to more easily earn licensure in other places that have reciprocal agreements.
What’s on the NBCE Exam?
The NBCE exam has five sections that students take at different times, although some states don’t require the last section. Students earning their DC typically take the exam before graduating and generally take each part at the school where they study.
It’s worth noting that the NBCE does not license chiropractors. Rather, it administers exams and provides scores to state licensing boards. States use those scores and other information, such as state-specific tests, to provide licensure.
The NBCE exam is made up of these sections:
What’s Included on State Tests?
Each state licensing test is different, so you will need to carefully research and prepare according to the requirements of the state where you’ll practice.
That said, commonalities cross state tests. Most state tests evaluate your grasp of the rules and regulations in your location, scope of practice, and requirements to maintain good standing as a chiropractor.
The process to take state tests varies, too. Some states offer testing on a continual basis; others offer testing on specific dates a limited number of times per year. Check with the state where you plan to practice for more information.
Licensing Requirements by State
All U.S. states, plus Washington, D.C., Puerto Rico, and the Virgin Islands, require passing scores on the NBCE exam. In addition, chiropractors must fulfill other requirements to become licensed.
States grant their own licenses, so steps vary. Make sure to check with local jurisdictions before you’re ready to apply for licensure. That way, you’ll have checked off everything you need—and won’t have unexpected delays.
Skip to the state where you plan to practice for more details. Remember: Always visit the state board’s website to ensure you have all the information you need.
Licensing Requirements by State
Alabama
Licensing Agency: Alabama State Board of Chiropractic Examiners
Minimum Education Required: Bachelor of Science and Doctor of Chiropractic
Continuing Education Required: 18 hours per fiscal year
Procedures Allowed with Licensure: Spinal manipulation, thermal treatments, nutritional advice
State Requirements:
Alaska
Licensing Agency: Alaska State Board of Chiropractic Examiners
Minimum Education Required: Two years of liberal arts education and Doctor of Chiropractic
Continuing Education Required: 32 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Arizona
Licensing Agency: State of Arizona Board of Chiropractic Examiners
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: 12 hours per year
Procedures Allowed with Licensure: Spinal manipulation, acupuncture, prescription of orthopedic supports, physiotherapy with passage of NBCE Physiotherapy exam
State Requirements:
Arkansas
Licensing Agency: Arkansas State Board of Chiropractic Examiners
Minimum Education Required: Two years of college education in the field of science and Doctor of Chiropractic
Continuing Education Required: 24 hours per year
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
California
Licensing Agency: California Board of Chiropractic Examiners
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: 24 hours per fiscal year
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Colorado
Licensing Agency: Colorado Board of Chiropractic Examiners
Minimum Education Required: None
Continuing Education Required: 15 hours per year
Procedures Allowed with Licensure: 15 hours per year
State Requirements: None
Connecticut
Licensing Agency: Connecticut State Board of Chiropractic Examiners
Minimum Education Required: Minimum 60 semester hours of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 48 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, acupuncture, nutritional advice, physiotherapy, and light, heat, water, or exercise therapy
State Requirements:
Delaware
Licensing Agency: Delaware Board of Chiropractic
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: 24 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
District of Columbia
Licensing Agency: Government of the District of Columbia Board of Chiropractic
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 24 hours every two years
Procedures Allowed with Licensure: Spinal manipulation; may earn Ancillary Procedures Cert, which includes physiotherapy and acupuncture
State Requirements:
Florida
Licensing Agency: Florida Board of Chiropractic Medicine
Minimum Education Required: Two to four years of undergraduate education (depending on when applicant entered chiropractic school; see site for details) and Doctor of Chiropractic
Continuing Education Required: 40 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, electrical therapy, thermal therapy, physiotherapy, and nutritional advice
State Requirements:
Georgia
Licensing Agency: Georgia Board of Chiropractic Examiners
Minimum Education Required: Two years of college education and Doctor of Chiropractic
Continuing Education Required: 20 hours per year
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Hawaii
Licensing Agency: Hawaii Board of Chiropractic
Minimum Education Required: 60 credits of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 20 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, hot or cold therapy, rehabilitative exercise, traction, electrical stimulation, and therapeutic ultrasound
State Requirements:
Idaho
Licensing Agency: Idaho Board of Chiropractic Physicians
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: 18 hours per year
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, and nutritional advice
State Requirements:
Illinois
Licensing Agency: Illinois Department of Financial and Professional Regulation
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 150 hours every three years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Indiana
Licensing Agency: Indiana State Board of Chiropractic Examiners
Minimum Education Required: Passage of NBCE Physiotherapy exam
Continuing Education Required: 12 hours per year
Procedures Allowed with Licensure: Spinal manipulation and physiotherapy
State Requirements:
Iowa
Licensing Agency: Iowa Board of Chiropractic
Minimum Education Required: Doctor of Chiropractic and 120 hours of physiotherapy education
Continuing Education Required: 40 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Kansas
Licensing Agency: Kansas State Board of Healing Arts
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 50 hours every 18 months
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, nutritional advice, and electrical therapy
State Requirements:
Kentucky
Licensing Agency: Kentucky State Board of Chiropractic Examiners
Minimum Education Required: 60 credit hours of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 12 hours per year
Procedures Allowed with Licensure: Spinal manipulation
State Requirements: None
Louisiana
Licensing Agency: Louisiana State Board of Chiropractic Examiners
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 15 hours per year
Procedures Allowed with Licensure: Spinal manipulation, therapeutic exercise, use of mechanical devices, and therapy with heat, light, water, electricity, and sound
State Requirements:
Maine
Licensing Agency: Maine Board of Chiropractic Licensure
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 48 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Maryland
Licensing Agency: Maryland Board of Chiropractic Examiners
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 48 hours every two years
Procedures Allowed with Licensure: Spinal manipulation and nutritional advice
State Requirements:
Massachusetts
Licensing Agency: Massachusetts Board of Registration of Chiropractors
Minimum Education Required: Two years undergraduate education and Doctor of Chiropractic
Continuing Education Required: 12 hours per term
Procedures Allowed with Licensure: Spinal manipulation, nutritional advice, traction, and therapy using heat, cold, sound, and electricity
State Requirements:
Michigan
Licensing Agency: Michigan Board of Chiropractic
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: 30 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, nutritional advice, rehabilitative exercise
State Requirements:
Minnesota
Licensing Agency: Minnesota Board of Chiropractic Examiners
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 20 hours per year
Procedures Allowed with Licensure: Spinal manipulation, rehabilitative therapy, acupuncture with completion of board-approved course of study and passage of exam
State Requirements:
Mississippi
Licensing Agency: Mississippi State Board of Chiropractic Examiners
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 12 hours per year
Procedures Allowed with Licensure: Spinal manipulation, traction, therapeutic ultrasound, therapy using light, heat, and electricity
State Requirements:
Missouri
Licensing Agency: Missouri State Board of Chiropractic Examiners
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: 48 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, meridian therapy, acupressure, and acupuncture with certification
State Requirements:
Montana
Licensing Agency: Montana Board of Chiropractors
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 13 hours per year
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, and nutritional advice
State Requirements:
Nebraska
Licensing Agency: Nebraska Board of Chiropractic
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 36 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, colonic irrigation, and nutritional advice
State Requirements:
Nevada
Licensing Agency: Nevada Board of Chiropractic Physicians
Minimum Education Required: 60 undergraduate credit hours and Doctor of Chiropractic
Continuing Education Required: 36 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, and nutritional advice
State Requirements:
New Hampshire
Licensing Agency: New Hampshire Board of Chiropractic Examiners
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: 20 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
New Jersey
Licensing Agency: New Jersey State Board of Chiropractic Examiners
Minimum Education Required: Passage of New Jersey jurisprudence exam
Continuing Education Required: 30 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, therapeutic exercise, and rehabilitative exercise
State Requirements:
New Mexico
Licensing Agency: New Mexico Chiropractic Board
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 16 hours per year
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, nutritional advice, and therapy using water, heat, cold, and electricity
State Requirements:
New York
Licensing Agency: New York State Office of the Professions
Minimum Education Required: 60 hours of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 36 hours every three years
Procedures Allowed with Licensure: Spinal manipulation and nutritional counseling
State Requirements: None
North Carolina
Licensing Agency: North Carolina Board of Chiropractic Examiners
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 18 hours per year
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
North Dakota
Licensing Agency: North Dakota State Board of Chiropractic Examiners
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 20 hours per year
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, hydrotherapy, and electrotherapy
State Requirements:
Ohio
Licensing Agency: Ohio State Chiropractic Board
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 36 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, nutritional advice, and rehabilitative therapy
State Requirements:
Oklahoma
Licensing Agency: Oklahoma Board of Chiropractic Examiners
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: Eight hours per year
Procedures Allowed with Licensure: Spinal manipulation and therapeutic measures approved by Board of Chiropractic Examiners
State Requirements:
Oregon
Licensing Agency: Oregon Board of Chiropractic Examiners
Minimum Education Required: Two years of undergraduate education, 36 hours minor surgery and proctology studies, and Doctor of Chiropractic
Continuing Education Required: 20 hours per year
Procedures Allowed with Licensure: Spinal manipulation, electrotherapy, hydrotherapy, minor surgery
State Requirements:
Pennsylvania
Licensing Agency: Pennsylvania State Board of Chiropractic
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 24 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, nutritional counseling, plus adjunctive procedures when chiropractor is licensed in those procedures
State Requirements:
Rhode Island
Licensing Agency: Rhode Island Board of Examiners in Chiropractic
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 60 hours every three years
Procedures Allowed with Licensure: Spinal manipulation, nutritional counseling, and use of electro-magnetic appliances
State Requirements:
South Carolina
Licensing Agency: South Carolina Board of Chiropractic Examiners
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 36 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
South Dakota
Licensing Agency: South Dakota Board of Chiropractic Examiners
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 40 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Tennessee
Licensing Agency: Tennessee Board of Chiropractic Examiners
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 24 hours per year
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Texas
Licensing Agency: Texas Board of Chiropractic Examiners
Minimum Education Required: 90 hours of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 32 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Utah
Licensing Agency: Utah Chiropractic Physicians Licensing Board
Minimum Education Required: Two years undergraduate education and Doctor of Chiropractic
Continuing Education Required: 40 hours every two years
Procedures Allowed with Licensure: Spinal manipulation and nutritional advice
State Requirements:
Vermont
Licensing Agency: Vermont Board of Chiropractic
Minimum Education Required: Two years undergraduate education and Doctor of Chiropractic
Continuing Education Required: 24 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Virginia
Licensing Agency: Virginia Board of Medicine
Minimum Education Required: Doctor of Chiropractic
Continuing Education Required: 60 hours every two years
Procedures Allowed with Licensure: Spinal manipulation
State Requirements: None
Washington
Licensing Agency: Washington Chiropractic Quality Assurance Commission
Minimum Education Required: Two years undergraduate education and Doctor of Chiropractic
Continuing Education Required: 25 hours per year
Procedures Allowed with Licensure: Spinal manipulation, exercise, massage, trigger point therapy, dietary advice, and therapies using heat, cold, and water
State Requirements:
West Virginia
Licensing Agency: West Virginia Board of Chiropractic
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 18 hours per year
Procedures Allowed with Licensure: Spinal manipulation
State Requirements:
Wisconsin
Licensing Agency: Wisconsin Chiropractic Examining Board
Minimum Education Required: Bachelor’s degree and Doctor of Chiropractic
Continuing Education Required: 40 hours every two years
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, and exercise rehabilitation
State Requirements:
Wyoming
Licensing Agency: Wyoming State Board of Chiropractic Examiners
Minimum Education Required: Two years of undergraduate education and Doctor of Chiropractic
Continuing Education Required: 12 hours per year
Procedures Allowed with Licensure: Spinal manipulation, physiotherapy, and nutritional advice
State Requirements:
What About Certifications?
All chiropractors must earn their doctorate, or DC. Diplomate certifications are optional opportunities for chiropractors to demonstrate an expertise. Different boards—not the NBCE—administer examinations to earn these diplomates.
Diplomates can be especially helpful in areas where competition for clients is tight, explains Danielle Fishel, DC, who practices in St. Louis. “It’s helpful to have that niche of a certification,” she says. “They can give you a leg up in business.”
She points out that certifications can also help clients feel more comfortable seeing a chiropractor. For example, Fishel is working on her diplomate in chiropractic pediatrics because her practice specializes in chiropractic for pregnant women, babies, and children.
Chiropractors can earn post-doctoral diplomates in nearly 20 specialties, from acupuncture to veterinary chiropractic.
To earn a diplomate, chiropractors must take courses that focus on the specialty. The number of credit hours varies, depending on the certifying board’s requirements. The specialty board also administers an exam and credentials chiropractors who have earned that certification.
“Earning a diplomate takes extra time, but it does help your practice grow,” Fishel says.
Chiropractors can earn post-doctoral diplomates in nearly 20 specialties.
Chiropractor Salary
You might be wondering how much a chiropractor earns. Salaries depend on factors like the state or city where you practice, if you have specialties or diplomates, and if you work in someone else’s practice or in your own.
In general, an associate in a medical office earns less than a chiropractor who runs their own practice. And the median salary for chiropractors in states such as Arizona, Georgia, and Nebraska is lower than in Connecticut, Hawaii, and Washington, according to the U.S. Bureau of Labor Statistics.
Beyond Licensure: More Ways to Advance in Your Chiropractic Career
Earning a diplomate to demonstrate your expertise in a topic such as nutrition or sports is not the only way to advance your chiropractic career.
Marketing can play a big role in your business’s success. How you talk about yourself, and how others talk about you, can help you become top-of-mind when someone is looking for a provider. Social media, earning media coverage, and offering expertise at conferences or group meetings are just a handful of ways to advance your career through marketing.
Focusing continuing education credits on a particular subject, such as migraines or car accident injuries, can help you stand out, too. Can you become the go-to chiropractor for a given issue?
Some chiropractors work their way through a typical career trajectory. They might start as an associate in another medical office, then become an independent contractor, and end up as the owner of a private practice.
Earning a specialty certificate, marketing your business, and owning your own practice are all ways you can advance your chiropractic career.
Building relationships with others can also move your chiropractic career forward. For example, you might resonate with an acupuncturist who refers clients to you, and you do the same for them. Networking, local chambers of commerce, and business referral organizations can all help you make the connections needed to refer—and get referrals for—clients.
“I go to networking meetings, I’m in Facebook groups, I’m in our chamber of commerce,” Fishel says. “Building my business like this helps my business grow, and I help others’ businesses grow, too.”
Written by:
Catherine Ryan Gregory
Contributing Writer
With professional insight from:
Danielle Fishel, DC
Owner, Fishel Chiropractic