Provider Demographics
NPI:1801597950
Name:ATLANTIC FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ATLANTIC FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANNIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ROMAN MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-501-8873
Mailing Address - Street 1:PO BOX 69001
Mailing Address - Street 2:SUITE 391
Mailing Address - City:HATILLO
Mailing Address - State:PR
Mailing Address - Zip Code:00659
Mailing Address - Country:US
Mailing Address - Phone:787-933-3611
Mailing Address - Fax:
Practice Address - Street 1:CARR. 2 KM. 79.7 MARGINAL JARDINES 7B
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-933-3611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty