Provider First Line Business Practice Location Address:
CARRETERA # 2 KM 174.0
Provider Second Line Business Practice Location Address:
SAN GERMAN MEDICAL PLAZA SUITE 202
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683-1905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-264-2124
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2006