Provider First Line Business Practice Location Address:
CALLE 11 Y VALLE VERDE
Provider Second Line Business Practice Location Address:
COL. BAJA CALIDORNIA
Provider Business Practice Location Address City Name:
MEXICALI
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
21130
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
686-551-4599
Provider Business Practice Location Address Fax Number:
686-551-4599
Provider Enumeration Date:
01/20/2009