Healthcare Provider Details
I. General information
NPI: 1598602609
Provider Name (Legal Business Name): SPINELAB CHIROPRACTIC AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3819 AVE ISLA VERDE APT 4B
CAROLINA PR
00979-6711
US
IV. Provider business mailing address
3819 AVE ISLA VERDE APT 4B
CAROLINA PR
00979-6711
US
V. Phone/Fax
- Phone: 787-637-7797
- Fax:
- Phone: 787-637-7797
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NI0013X |
| Taxonomy | Independent Medical Examiner Chiropractor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NP0017X |
| Taxonomy | Pediatric Chiropractor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHELLE
MONTCOURT
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 787-637-7797