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General NPI Number Information
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NPI Number | 1578927257
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Entity Type | Organization
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Legal Business Name | FREEDOM CHIROPRACTIC, PSC
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 1078 CALLE JOSE E ARRARAS
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City | MAYAGUEZ
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State | PR
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Zip | 00682-6601
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Country | US
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Telephone | 787-833-4510
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Fax | 787-833-4510
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Provider Business Mailing Address
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Address Line | 1078 CALLE JOSE E ARRARAS
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City | MAYAGUEZ
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State | PR
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Zip | 00682
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Country | US
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Telephone | 787-833-4510
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Fax | 787-833-4510
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. RONALD ANDREW MANNS
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Credential | D.C.
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Telephone | 787-833-4510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 387
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License Number State | PR
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