Provider First Line Business Practice Location Address:
EDIF. PROFESIONAL HOSPITAL MENONITA SUITE 201
Provider Second Line Business Practice Location Address:
BOX 1379
Provider Business Practice Location Address City Name:
AIBONITO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00705-1379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-735-8998
Provider Business Practice Location Address Fax Number:
787-735-7135
Provider Enumeration Date:
06/14/2006