Provider Demographics
NPI:1407404999
Name:ORTIZ TORRES, CHRISTIAN IVAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:IVAN
Last Name:ORTIZ TORRES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 AVE JESUS T. PINERO
Mailing Address - Street 2:LOCAL #3
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00927
Mailing Address - Country:US
Mailing Address - Phone:787-368-4221
Mailing Address - Fax:
Practice Address - Street 1:254 AVE JESUS T. PINERO
Practice Address - Street 2:LOCAL #3
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00927
Practice Address - Country:US
Practice Address - Phone:787-368-4221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR679111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor