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General NPI Number Information
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NPI Number | 1306199062
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Entity Type | Organization
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Legal Business Name | QUIROPRACTICA DEL ENCANTO, CSP
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 02/11/2022
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Provider Practice Location Address
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Address Line | 1751 AVE PAZ GRANELA URB SANTIAGO IGLESIAS
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City | SAN JUAN
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State | PR
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Zip | 00921-3630
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Country | US
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Telephone | 787-200-9144
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Fax | 789-200-9108
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Provider Business Mailing Address
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Address Line | 1751 AVE PAZ GRANELA URB SANTIAGO IGLESIAS
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City | SAN JUAN
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State | PR
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Zip | 00921-3630
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Country | US
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Telephone | 787-200-9144
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Fax | 789-200-9108
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. EDWIN JAVIER VELEZ-CORREA
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Credential | DC
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Telephone | 789-500-3000
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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 | 507
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License Number State | PR
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