Provider First Line Business Practice Location Address:
RD#14 BO MACHUELO
Provider Second Line Business Practice Location Address:
ADM SERV SALUD MENT CONT ADIC CEDE METADONA
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00732-7321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-840-6935
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2010