Provider First Line Business Practice Location Address:
SON GERMAN MEDICAL PLAZA CARR 2 KM 174
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683-0188
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-892-1010
Provider Business Practice Location Address Fax Number:
787-892-1011
Provider Enumeration Date:
08/30/2006