Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 570 | PR |
N | 111NR0400X | Rehabilitation Chiropractor | 570 | PR |
NPI | 1376962118 |
---|---|
Provider Name | Annabelle Rivera Buscaglia |
First Address | San Juan, PR 00907-1591 |
Second Address | San Juan, PR 00921-4810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2014 |
Last Update Date | 16/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1902266968 | CHIRO CARE PUERTO RICO (01) | PR |