Provider Demographics
NPI:1023164720
Name:CENTRO QUIROPRACTICO DEL NOROESTE
Entity type:Organization
Organization Name:CENTRO QUIROPRACTICO DEL NOROESTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR,ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-872-6699
Mailing Address - Street 1:PO BOX 1957
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-1957
Mailing Address - Country:US
Mailing Address - Phone:787-872-6699
Mailing Address - Fax:
Practice Address - Street 1:57 CALLE OTERO
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-3010
Practice Address - Country:US
Practice Address - Phone:787-872-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR400111N00000X
PR401111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR=========OtherMCS
PR=========OtherMAPFRE
PR=========OtherLCA
PR=========OtherMCS CLASSICARE
PR=========OtherHUMANA
PR=========OtherTRIPLE S
PR=========OtherCOSVI
PR=========OtherPMC
PR=========OtherMMM