Provider First Line Business Practice Location Address:
ARECIBO MEDICAL PLAZA
Provider Second Line Business Practice Location Address:
AVE. BARBOSA # 65 SUITE # 105
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-2746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-5785
Provider Business Practice Location Address Fax Number:
787-817-5288
Provider Enumeration Date:
09/22/2006