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General NPI Number Information
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NPI Number | 1194497867
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC RADIOLOGY IMAGING LLC
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Dates
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Enumeration Date | 10/01/2021
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Last Update Date | 11/15/2021
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Provider Practice Location Address
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Address Line | CARR.14 KM.31.5 BARRIO SAN ILDEFONSO BOULEVARD PIEL CANELA SUITE#3
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City | COAMO
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State | PR
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Zip | 00769
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Country | US
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Telephone | 787-238-6030
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Fax |
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Provider Business Mailing Address
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Address Line | URB. ALTURAS DE COAMO 227 CALLE CALIZA
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City | COAMO
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State | PR
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Zip | 00769-4807
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Country | US
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Telephone | 787-238-6030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANYSHA YVETTE FLORES GONZALEZ
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Credential | MPH
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Telephone | 407-223-1372
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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 |
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License Number State |
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