Provider Demographics
NPI:1912166331
Name:GRUPO QUIROPRACTICO DEL NORTE, CSP
Entity Type:Organization
Organization Name:GRUPO QUIROPRACTICO DEL NORTE, CSP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARRAIZA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-607-8490
Mailing Address - Street 1:PO BOX 1015
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613
Mailing Address - Country:US
Mailing Address - Phone:787-816-7219
Mailing Address - Fax:
Practice Address - Street 1:TRINA PADILLA DE SANZ ST #51
Practice Address - Street 2:
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-879-8038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRU91421Medicare UPIN