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General NPI Number Information
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NPI Number | 1356055834
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Entity Type | Organization
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Legal Business Name | QUIROPRACTICA VIVA NATURAL CSP
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | CARR #2 KM 97.0 BO COCOS
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City | QUEBRADILLAS
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State | PR
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Zip | 00678
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Country | US
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Telephone | 787-930-3389
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Fax |
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Provider Business Mailing Address
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Address Line | 10 HACIENDA TERRA LINDA
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City | CAMUY
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State | PR
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Zip | 00627-9760
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Country | US
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Telephone | 787-930-3389
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. CAMILLE ANDREA RIVERA
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Credential | DC
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Telephone | 787-930-3389
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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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