Provider Demographics
NPI:1578927257
Name:FREEDOM CHIROPRACTIC, PSC
Entity Type:Organization
Organization Name:FREEDOM CHIROPRACTIC, PSC
Other - Org Name:CENTRO QUIROPRACTICO DEL OESTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:MANNS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-833-4510
Mailing Address - Street 1:1078 CALLE JOSE E ARRARAS
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00682
Mailing Address - Country:US
Mailing Address - Phone:787-833-4510
Mailing Address - Fax:787-833-4510
Practice Address - Street 1:1078 CALLE JOSE E ARRARAS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-6601
Practice Address - Country:US
Practice Address - Phone:787-833-4510
Practice Address - Fax:787-833-4510
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR387261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service