Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 633 | PR |
NPI | 1922526516 |
---|---|
Provider Name | Dr. Elsie Michelle Candelaria Reyes |
First Address | Caguas, PR 00727-3147 |
Second Address | San Juan, PR 00917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2017 |
Last Update Date | 21/05/2018 |