Provider Demographics
NPI:1730816547
Name:JOHO ESTUDIO QUIROPRACTICO LLC
Entity type:Organization
Organization Name:JOHO ESTUDIO QUIROPRACTICO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHANSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:787-548-6380
Mailing Address - Street 1:500 GRAND BLVD LOS PRADOS
Mailing Address - Street 2:APARTADO 25101
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-989-4222
Mailing Address - Fax:
Practice Address - Street 1:URB MENDEZ HORMAZABAL
Practice Address - Street 2:CALLE LUIS MUNOZ RIVERA 23
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777
Practice Address - Country:US
Practice Address - Phone:787-989-4222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty