Provider First Line Business Practice Location Address:
EAST MEDICAL & PROFFESSIONAL CENTER
Provider Second Line Business Practice Location Address:
CARRETERA #3 KM 19.9
Provider Business Practice Location Address City Name:
CANOVANAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-256-5555
Provider Business Practice Location Address Fax Number:
787-256-5555
Provider Enumeration Date:
02/19/2009