=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669850079
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CENTRO QUIROPRACTICO ALLCARE HEALTH REHABILITATION P.S.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/18/2015
-----------------------------------------------------
Last Update Date | 05/18/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 150 JESUS CORTES TORRES
-----------------------------------------------------
City | ARECIBO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-218-1218
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 235
-----------------------------------------------------
City | ARECIBO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00613-0235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-218-1218
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. YARELIE RIVERA
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 787-218-1218
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------