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General NPI Number Information
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NPI Number | 1073044194
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Entity Type | Organization
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Legal Business Name | BIENESTAR QUIROPRACTICO DR MARQUEZ COLLAZO CSP
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 03/21/2017
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Provider Practice Location Address
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Address Line | 6501 CAMINOS VERDES CARR 844 ATP 603
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City | SAN JUAN
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State | PR
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Zip | 00926-7826
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Country | US
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Telephone | 787-605-3188
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Fax |
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Provider Business Mailing Address
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Address Line | 6501 CAMINOS VERDES CARR. 844 , ATP. 603
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City | SAN JUAN
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State | PR
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Zip | 00926
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Country | UM
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Telephone | 787-605-3188
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANDRE J MARQUEZ
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Credential | D.C.
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Telephone | 787-605-3188
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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 | 518
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License Number State | PR
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