Provider First Line Business Practice Location Address:
AVE HOSTOS #216
Provider Second Line Business Practice Location Address:
CENTRO DE DIAGNOSTICO Y TRATAMIENTO PLAYA DE PONCE
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00734-4254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-843-9393
Provider Business Practice Location Address Fax Number:
787-841-0993
Provider Enumeration Date:
07/31/2006