Provider Demographics
NPI:1356039028
Name:INTEGRA QUIROPRACTICA LLC
Entity type:Organization
Organization Name:INTEGRA QUIROPRACTICA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANAIRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:939-355-0155
Mailing Address - Street 1:PO BOX 30811
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00929-1811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:146 CALLE 2B
Practice Address - Street 2:
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985-5906
Practice Address - Country:US
Practice Address - Phone:939-355-0155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty