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General NPI Number Information
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NPI Number | 1720709538
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Entity Type | Organization
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Legal Business Name | VIVE QUIROPRACTICA
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Dates
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Enumeration Date | 09/09/2022
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 9 CALLE BARCELO BLDG SUITE102
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City | BARRANQUITAS
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State | PR
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Zip | 00794-1779
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Country | US
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Telephone | 939-409-0529
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Fax |
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Provider Business Mailing Address
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Address Line | 9 CALLE BARCELO BLDG SUITE102
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City | BARRANQUITAS
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State | PR
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Zip | 00794-1779
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Country | US
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Telephone | 939-409-0529
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | PAOLA Z LASANTA
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Credential | DC
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Telephone | 939-409-0529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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