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General NPI Number Information
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NPI Number | 1922394568
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC CLINICS OF PUERTO RICO, LLC
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | ESQUINA CALLE D Y E, BARRIO LOS FRAILES EDIFICIO CARIBBEAN CINEMAS STE 205
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City | GUAYNABO
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State | PR
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Zip | 00969-4466
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Country | US
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Telephone | 787-790-7855
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Fax |
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Provider Business Mailing Address
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Address Line | 405 AVE ESMERALDA STE 102
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City | GUAYNABO
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State | PR
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Zip | 00969-4466
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Country | US
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Telephone | 787-790-7855
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RUBEN VALDES
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Credential | D.C.
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Telephone | 787-790-7855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 453
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License Number State | PR
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