Basic Information
| Provider Information | |||||||||
| NPI: | 1043850290 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HEALTH CHIROPRACTIC PR | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2059 | ||||||||
| Address2: | |||||||||
| City: | CANOVANAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007292059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872218828 | ||||||||
| FaxNumber: | 7879614864 | ||||||||
| Practice Location | |||||||||
| Address1: | CARR #3 K.M 19.9 BARRIO DOS CUERDAS | ||||||||
| Address2: | |||||||||
| City: | CANOVANAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 007292059 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872218828 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2020 | ||||||||
| LastUpdateDate: | 01/15/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | VALENTIN | ||||||||
| AuthorizedOfficialFirstName: | ALEXIS | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7874248541 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DC | ||||||||
| NPICertificationDate: | 01/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.