Provider First Line Business Practice Location Address:
39 CARR 2
Provider Second Line Business Practice Location Address:
HOSPITAL WILMA N VAZQUEZ SUITE 101
Provider Business Practice Location Address City Name:
VEGA BAJA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00693-4824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-858-3550
Provider Business Practice Location Address Fax Number:
787-855-3339
Provider Enumeration Date:
02/09/2017