Chiropractic shows split citation engines by city. Chicago is cited in Google AIO (2 of 5 queries); Houston in ChatGPT (1 of 5). Neither appears in the other's primary engine. Atlanta gets no citations. The common factor for cited businesses is health directory presence — Healthgrades, Zocdoc, and Vitals. The common gap for Atlanta is absence from these directories.
2 of 3
Chiropractic is cited in 2 cities but via different engines
Chicago Chiropractic is cited in Google AIO. Houston Chiropractic is cited in ChatGPT. Neither appears in the other's primary engine. This suggests each AI engine draws from different source sets for chiropractic recommendations. Businesses should optimize for both engines, not just one.
Healthgrades
Health directory presence is the citation signal — Healthgrades, Zocdoc, Vitals
The cited Chicago and Houston businesses have active health directory profiles. The uncited Atlanta business does not. In a YMYL category like chiropractic, AI engines prioritize health-specific directory presence as a trust signal over general business directories. This is distinct from the aggregator pattern seen in plumbing and pest control.
NPI
NPI number and licensed practitioner credentials matter in this YMYL category
AI engines apply elevated trust thresholds to health recommendations. For chiropractic, NPI numbers, licensed practitioner credentials, and clinic accreditation are meaningful citation signals. Businesses with credentials in structured schema score higher in the B5 (Entity Recognition) component.
57 vs 37
20-point gap between Chicago and Atlanta — same tier, opposite citation outcomes
Chicago Chiropractic (57) and Atlanta Chiropractic (37) are both Mid tier, but one is cited and the other isn't. The 20-point gap is driven by health directory presence and structured credential data. Atlanta has consistent NAP and a 4.9 GBP rating — traditional signals are solid. The gap is health-specific citation sources.