Provider First Line Business Practice Location Address:
MCKINLEY 25 WEST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-832-3114
Provider Business Practice Location Address Fax Number:
787-832-3114
Provider Enumeration Date:
11/30/2005