Provider First Line Business Practice Location Address:
668 HERNANDEZ CARRION STREET ATENAS AVE
Provider Second Line Business Practice Location Address:
MANATI MEDICAL CENTER HOSP. SUITE 104B
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-4170
Provider Business Practice Location Address Fax Number:
787-854-4493
Provider Enumeration Date:
01/27/2009