Provider First Line Business Practice Location Address:
CARRETERA # 3 KM 19.9
Provider Second Line Business Practice Location Address:
EDIFICIO EAST MEDICAL PROFESSIONAL CENTER
Provider Business Practice Location Address City Name:
CANOVANAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00729
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-256-6060
Provider Business Practice Location Address Fax Number:
787-256-6061
Provider Enumeration Date:
02/05/2008