Provider Demographics
NPI:1598143513
Name:WEST SPINE P.S.C
Entity Type:Organization
Organization Name:WEST SPINE P.S.C
Other - Org Name:DR. JOSE NEGRON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEGRON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:939-292-3119
Mailing Address - Street 1:PO BOX 1861
Mailing Address - Street 2:
Mailing Address - City:ANASCO
Mailing Address - State:PR
Mailing Address - Zip Code:00610
Mailing Address - Country:US
Mailing Address - Phone:939-292-3119
Mailing Address - Fax:
Practice Address - Street 1:770 AVE HOSTOS
Practice Address - Street 2:SUITE 302B
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1551
Practice Address - Country:US
Practice Address - Phone:939-292-3119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty