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General NPI Number Information
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NPI Number | 1386706380
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Entity Type | Organization
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Legal Business Name | CLINICA QUIROPRACTICA DR HECTOR R CARRASQUILLO CSP
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Dates
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Enumeration Date | 12/15/2006
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 54 CALLE CELIS AGUILERA N
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City | FAJARDO
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State | PR
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Zip | 00738-4811
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Country | US
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Telephone | 787-860-6373
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Fax | 787-863-5454
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Provider Business Mailing Address
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Address Line | 54 CALLE CELIS AGUILERA N
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City | FAJARDO
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State | PR
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Zip | 00738-4811
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Country | US
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Telephone | 787-860-6373
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Fax | 787-863-5454
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARBELLA HERRERA
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Credential | MS
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Telephone | 787-860-6373
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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 | 324
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License Number State | PR
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