Provider Demographics
NPI:1932828399
Name:GLOW & BLOOM CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:GLOW & BLOOM CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBARRAN VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-239-3406
Mailing Address - Street 1:PO BOX 143811
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-3811
Mailing Address - Country:US
Mailing Address - Phone:787-239-3406
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 12.5 METRO MEDICAL CENTER
Practice Address - Street 2:SUITE 102-A
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-244-5583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty