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General NPI Number Information
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NPI Number | 1679144505
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Entity Type | Individual
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Provider Name | JEANETTE MARIE TORRES CRUZ DC, PTA
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Gender | Female
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Dates
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Enumeration Date | 07/01/2021
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 451 AVE HOSTOS
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City | SAN JUAN
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State | PR
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Zip | 00918-3014
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Country | US
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Telephone | 787-422-7469
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Fax |
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Provider Business Mailing Address
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Address Line | URB.SIERRA BAYAMON C/45 66-11
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City | BAYAMON
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State | PR
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Zip | 00961
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Country | US
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Telephone | 787-422-7469
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 761
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License Number State | PR
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