Healthcare Provider Details

I. General information

NPI: 1124455332
Provider Name (Legal Business Name): PAIN BUSTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2013
Last Update Date: 10/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1475 CALLE WILSON STE 4A
SAN JUAN PR
00907-2315
US

IV. Provider business mailing address

1475 CALLE WILSON STE 4A
SAN JUAN PR
00907-2315
US

V. Phone/Fax

Practice location:
  • Phone: 787-550-9166
  • Fax:
Mailing address:
  • Phone: 787-550-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number662
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number0017
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0017
License Number StatePR

VIII. Authorized Official

Name: MR. JAMES NORMAN
Title or Position: OWNER
Credential: LMT
Phone: 787-550-9166