Provider Demographics
NPI:1265773972
Name:INVOGA CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:INVOGA CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMAYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MATOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-562-1127
Mailing Address - Street 1:27 CALLE VIOLETA
Mailing Address - Street 2:CIUDAD JARDIN 3
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-4866
Mailing Address - Country:US
Mailing Address - Phone:787-562-1127
Mailing Address - Fax:
Practice Address - Street 1:27 CALLE VIOLETA
Practice Address - Street 2:CIUDAD JARDIN 3
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-4866
Practice Address - Country:US
Practice Address - Phone:787-562-1127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty