1326854712 NPI number — JR CHIROPRACTIC MANAGEMENT GROUP, CSP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326854712 NPI number — JR CHIROPRACTIC MANAGEMENT GROUP, CSP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JR CHIROPRACTIC MANAGEMENT GROUP, CSP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326854712
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1368
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CABO ROJO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00623-1368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-647-3511
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CENTRO PROFESIONAL DEL SUR CARR 121 KM. 13
Provider Second Line Business Practice Location Address:
SECTOR CUATRO CALLES SUSUA BAJA
Provider Business Practice Location Address City Name:
YAUCO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-992-1019
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2024

Additional Information

Authorized Official

Authorized Official Last Name:
CRUZ TROCHE
Authorized Official First Name:
JOSE
Authorized Official Middle Name:
ANGEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
787-647-3511

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com