Healthcare Provider Details

I. General information

NPI: 1790882090
Provider Name (Legal Business Name): QUIROPRACTICA FAMILIAR WILLIAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

N-42 CALLE MARGINAL FAGOT BOULEVARD MIGUEL POU
PONCE PR
00716-2648
US

IV. Provider business mailing address

2061 CALLE YAGRUMO URB. LOS CAOBOS
PONCE PR
00716-2648
US

V. Phone/Fax

Practice location:
  • Phone: 787-848-5599
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES E WILLIAMS
Title or Position: CEO
Credential:
Phone: 787-848-5599