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General NPI Number Information
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NPI Number | 1013075019
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Entity Type | Organization
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Legal Business Name | CENTRO QUIROPRACTICO FAMILIAR P.S.C.
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1761 CARR 8838 BO MONACILLOS
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | US
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Telephone | 787-758-7813
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Fax |
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Provider Business Mailing Address
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Address Line | 138 AVE WINSTON CHURCHILL PMB 138
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City | SAN JUAN
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State | PR
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Zip | 00926-6013
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Country | US
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Telephone | 787-758-7813
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MARIA EUGENIA REYNA
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Credential | D.C.
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Telephone | 787-758-7813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 422
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License Number State | PR
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