Healthcare Provider Details

I. General information

NPI: 1962369199
Provider Name (Legal Business Name): LUX CHIROPRACTIC & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LOMAS VERDES 4X15 NOGAL
BAYAMON PR
00956
US

IV. Provider business mailing address

1430 AVE SAN ALFONSO APT 1902
SAN JUAN PR
00921-4662
US

V. Phone/Fax

Practice location:
  • Phone: 787-929-2438
  • Fax:
Mailing address:
  • Phone: 787-593-3035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ISSELINE LEDESMA RIVERA
Title or Position: CHIROPRACTIC CLINICIAN AND CO-OWNER
Credential: D.C
Phone: 787-593-3035