Provider Demographics
NPI:1528206299
Name:ADAMARI GOMEZ VILLEGAS
Entity Type:Organization
Organization Name:ADAMARI GOMEZ VILLEGAS
Other - Org Name:EAST CHIROPRACTIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAMARI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOMEZ VILLEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-850-8989
Mailing Address - Street 1:PO BOX 8388
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00792-8388
Mailing Address - Country:US
Mailing Address - Phone:787-850-8989
Mailing Address - Fax:
Practice Address - Street 1:63 AVE. PADRE RIVERA
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-850-8989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR442261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center