Provider First Line Business Practice Location Address:
EXPRESO TRUJILLO ALTO KM 4.4
Provider Second Line Business Practice Location Address:
SAN MIGUEL MEDICAL - SUITE 204 PLAZA SAN MIGUEL
Provider Business Practice Location Address City Name:
TRUJILLO ALTO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-748-7120
Provider Business Practice Location Address Fax Number:
787-748-7105
Provider Enumeration Date:
07/15/2005