Provider Demographics
NPI:1609510528
Name:MIQUIROPRACTICOPR LLC
Entity Type:Organization
Organization Name:MIQUIROPRACTICOPR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-667-5711
Mailing Address - Street 1:6981 CARR 187 APT 15A
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979-7057
Mailing Address - Country:US
Mailing Address - Phone:787-667-5898
Mailing Address - Fax:
Practice Address - Street 1:1665 AVE VCTR LABIOSA STE 106
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4149
Practice Address - Country:US
Practice Address - Phone:787-223-9160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty