Provider Demographics
NPI:1356168702
Name:TU CLINICA QUIROPRACTICA DRA. YADIRA SANTIAGO LLC
Entity type:Organization
Organization Name:TU CLINICA QUIROPRACTICA DRA. YADIRA SANTIAGO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:864-308-6873
Mailing Address - Street 1:315 AVE. ING. DOMENECH
Mailing Address - Street 2:STE. 4
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-1328
Mailing Address - Country:US
Mailing Address - Phone:939-649-2520
Mailing Address - Fax:
Practice Address - Street 1:315 AVE. ING. MANUEL DOMENECH
Practice Address - Street 2:STE 4
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918
Practice Address - Country:US
Practice Address - Phone:939-649-2520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty