Provider Demographics
NPI:1093568115
Name:OPCHIROPRACTIC LLC
Entity Type:Organization
Organization Name:OPCHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUIROPRACTICO
Authorized Official - Prefix:
Authorized Official - First Name:ABELLA DIAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:RICARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-403-0703
Mailing Address - Street 1:PO BOX 363094
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-3094
Mailing Address - Country:US
Mailing Address - Phone:787-403-0703
Mailing Address - Fax:
Practice Address - Street 1:PASEO CRESTA
Practice Address - Street 2:E3178
Practice Address - City:LEVITOWN
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-403-0703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty