Provider First Line Business Practice Location Address:
CALLE BARBOSA #14 ESQ, CALLE DIOSDADO
Provider Second Line Business Practice Location Address:
COMUNIDAD EL COCO BARRIO LAPAS
Provider Business Practice Location Address City Name:
SALINAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00751-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-839-4320
Provider Business Practice Location Address Fax Number:
787-271-0004
Provider Enumeration Date:
03/23/2022