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General NPI Number Information
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NPI Number | 1073523080
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Entity Type | Individual
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Provider Name | JUAN ESTEBAN OTERO D.C.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 11 CALLE MARGINAL ROBERTO CLEMENTE AVE.
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City | CAROLINA
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State | PR
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Zip | 00979-6328
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Country | US
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Telephone | 787-762-9287
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Fax |
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Provider Business Mailing Address
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Address Line | 1306 AVE MONTE CARLO APT 187 PORTAL DE LA REINA
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City | SAN JUAN
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State | PR
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Zip | 00924-5749
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Country | US
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Telephone | 787-762-9287
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Fax | 787-762-9287
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0357
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License Number State | PR
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