# MODERN SPINE CHIROPRACTIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679265417
- **Authorized official:** RAFAEL M MIRANDA DC (PRESIDENT)
- **Authorized official phone:** (787) 486-7919

## Contact information

- **Practice address:** 1228 AVE MUNOZ RIVERA STE 1, PONCE, PR 00717-0639
- **Practice address phone:** (939) 500-0649
- **Mailing address:** URB LAS ALONDRAS A10 CALLE 1, VILLALBA, PR 00766-2301
- **Mailing address phone:** (787) 486-7919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | Yes |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2023
- **Last updated:** 05/22/2023