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General NPI Number Information
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NPI Number | 1962269183
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC SPINE SOLUTIONS LLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | AVENIDA PEREZ ANDINO C-1 URB. VILLAS DE RIO GRANDE
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City | RIO GRANDE
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State | PR
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Zip | 00745
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Country | US
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Telephone | 787-313-1607
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Fax |
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Provider Business Mailing Address
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Address Line | PMB 459 PO BOX 30000
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City | CANOVANAS
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State | PR
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Zip | 00729
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Country | US
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Telephone | 787-313-1607
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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. MYRELIZ CASILLAS MANGUAL
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Credential | DC
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Telephone | 787-313-1607
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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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