Rankings are not the problem. Proximity and reviews are.
Chiropractors get sold SEO like it is a national game. It is not. Google ranks local results on relevance, distance, and prominence, and distance is not something an agency can change. What we can change is how complete your profile is, how many recent reviews you have, and whether your categories and services match what people type.
A practice can rank first for chiropractor plus the city name and still sit by a quiet phone, because that is not where the searches land. They land on chiropractor near me, back pain relief near me, and the specific technique or condition. Those are separate battles.