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NPI Code Detail

MEDICARE: ST ROCHS CHRONIC PAIN PROGRAM

MEDICARE: ST ROCHS CHRONIC PAIN PROGRAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NX0100XOccupational Health Chiropractor

General Provider Information

NPI Number : 1023297181
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST ROCHS CHRONIC PAIN PROGRAM
Provider Business Mailing Address
First Line : 96 CROSSROADS BLVD
Second Line : 201
City : SAN ANTONIO
State : TX
Zip : 78201-6523
Country : US
Telephone Number : 210-733-9090
Fax Number :
Provider Business Practice Location Address
First Line : 96 CROSSROADS BLVD
Second Line : 201
City : SAN ANTONIO
State : TX
Zip : 78201-6523
Country : US
Telephone Number : 210-733-9090
Fax Number :
Authorized Official
Title or Position : OWNER-PARTNER
Name : JULIO C REGALADO
Credential : DC-
Telephone Number : 210-733-9090
Provider Enumeration Date : 10/25/2007
Last Update Date : 10/25/2007

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Directions to “ST ROCHS CHRONIC PAIN PROGRAM ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.