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General NPI Number Information
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NPI Number | 1609510528
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Entity Type | Organization
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Legal Business Name | MIQUIROPRACTICOPR LLC
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 1665 AVE VCTR LABIOSA STE 106
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City | SAN JUAN
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State | PR
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Zip | 00926-4149
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Country | US
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Telephone | 787-223-9160
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Fax |
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Provider Business Mailing Address
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Address Line | 6981 CARR 187 APT 15A
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City | CAROLINA
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State | PR
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Zip | 00979-7057
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Country | US
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Telephone | 787-667-5898
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JULIE S MARTINEZ
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Credential |
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Telephone | 787-667-5711
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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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