Basic Information
| Provider Information | |||||||||
| NPI: | 1700326865 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CLEMENTE MORALES | ||||||||
| FirstName: | ESTEBAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | URB. VILLA HUMACAO L-60 CALLE#3 | ||||||||
| Address2: | |||||||||
| City: | HUMACAO | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00791 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9392682901 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | CARR 3 KM 19.23 2NDO PISO | ||||||||
| Address2: | BO CANOVANAS | ||||||||
| City: | CANOVANAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00729 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7872218828 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2017 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 12121 | TX | N | Chiropractic Providers | Chiropractor | 111N00000X | 510 | PR | Y | Chiropractic Providers | Chiropractor |
No ID Information.