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General NPI Number Information
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NPI Number | 1780241828
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Entity Type | Organization
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Legal Business Name | BALANCED CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 134 AVE DOMENECH
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City | SAN JUAN
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State | PR
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Zip | 00918-3502
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Country | US
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Telephone | 787-467-1017
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Fax | 787-957-6692
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Provider Business Mailing Address
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Address Line | 134 AVE DOMENECH
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City | SAN JUAN
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State | PR
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Zip | 00918-3502
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Country | US
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Telephone | 787-467-1017
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR / PRESIDENT
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Name | DR. ANDRE COLON PEREZ
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Credential | DC
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Telephone | 787-957-6691
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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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