Provider First Line Business Practice Location Address:
CARR 844 KM 3 0 CUPEY BAJO
Provider Second Line Business Practice Location Address:
FARMACIA DEL CARMEN
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-748-0880
Provider Business Practice Location Address Fax Number:
787-760-1399
Provider Enumeration Date:
10/26/2006