Provider Demographics
NPI:1881429231
Name:PR DECOMPRESSION CENTERS LLC
Entity type:Organization
Organization Name:PR DECOMPRESSION CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AIVIN
Authorized Official - Middle Name:ASHYADETTE
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-587-1691
Mailing Address - Street 1:5859 AVE ISLA VERDE APT 1714 TORRE 2
Mailing Address - Street 2:COND CORAL BEACH
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-587-1691
Mailing Address - Fax:
Practice Address - Street 1:URB ROSALEDA II
Practice Address - Street 2:RH 16 CALLE ACACIA
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949
Practice Address - Country:US
Practice Address - Phone:787-587-1691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-05
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty