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General NPI Number Information
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NPI Number | 1851190755
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Entity Type | Organization
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Legal Business Name | ISLAND CHIROPRACTIC STUDIO, LLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 714 CALLE FERROCARRIL
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City | PONCE
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State | PR
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Zip | 00717-1108
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Country | US
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Telephone | 787-709-7208
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8329
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City | PONCE
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State | PR
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Zip | 00732-8329
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Country | US
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Telephone | 787-709-7208
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. RAIXAMARIE PACHECO CAQUIAS
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Credential | DC
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Telephone | 787-601-3937
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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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