MEDICARE: HEALING HANDS CHIROPRACTIC CLINIC CORP

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
1	111N00000X	Chiropractor	637	PR

General Provider Information

NPI Number	:	1356854186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING HANDS CHIROPRACTIC CLINIC CORP

Provider Business Mailing Address
First Line	:	11 CALLE DON CHEMARY
Second Line	:
City	:	MOCA
State	:	PR
Zip	:	00676-4120
Country	:	US
Telephone Number	:	939-216-8165
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 CALLE DON CHEMARY
Second Line	:
City	:	MOCA
State	:	PR
Zip	:	00676-4120
Country	:	US
Telephone Number	:	939-216-8165
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. ERIC J GONZALEZ
Credential	:	DC
Telephone Number	:	939-216-8165

Provider Enumeration Date	:	11/15/2017
Last Update Date	:	05/25/2020

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