Provider Demographics
NPI:1639490147
Name:CLINICA DE TERAPIA MANUAL, CRL
Entity Type:Organization
Organization Name:CLINICA DE TERAPIA MANUAL, CRL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-306-2764
Mailing Address - Street 1:URB PASEO JACARANDA C/ UCAR 15031
Mailing Address - Street 2:
Mailing Address - City:SANTA ISABEL
Mailing Address - State:PR
Mailing Address - Zip Code:00757-9600
Mailing Address - Country:US
Mailing Address - Phone:787-306-2764
Mailing Address - Fax:
Practice Address - Street 1:576 CESAR GONZALEZ AVE. SUITE 504, DORAL BANK CENTER
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:787-306-2764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy