Provider First Line Business Practice Location Address:
CALLE SAN ANTONIO 1870-A
Provider Second Line Business Practice Location Address:
IMCS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-726-9620
Provider Business Practice Location Address Fax Number:
787-726-1720
Provider Enumeration Date:
01/14/2008