Provider Demographics
NPI:1790882090
Name:QUIROPRACTICA FAMILIAR WILLIAMS
Entity Type:Organization
Organization Name:QUIROPRACTICA FAMILIAR WILLIAMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-848-5599
Mailing Address - Street 1:2061 CALLE YAGRUMO
Mailing Address - Street 2:URB. LOS CAOBOS
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-2648
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:N-42 CALLE MARGINAL FAGOT
Practice Address - Street 2:BOULEVARD MIGUEL POU
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-2648
Practice Address - Country:US
Practice Address - Phone:787-848-5599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100215OtherCRUZ AZUL
PR7660030OtherHUMANA
PR68202WIOtherTRIPLESSS