Provider First Line Business Practice Location Address:
65 AVE BARBOSA
Provider Second Line Business Practice Location Address:
ARECIBO MEDICAL PLAZA, SUITE 102
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-2799
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-879-4811
Provider Business Practice Location Address Fax Number:
787-879-4811
Provider Enumeration Date:
10/12/2006