Provider First Line Business Practice Location Address:
351 AVE HOSTOS SUITE 212
Provider Second Line Business Practice Location Address:
MEDICAL EMPORIUM
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680-1502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-834-4536
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/12/2007