Provider First Line Business Practice Location Address:
CALLE JOSE CANDELAS #1 MANATI MEDICAL PLAZA
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-5507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-5063
Provider Business Practice Location Address Fax Number:
225-310-8212
Provider Enumeration Date:
09/22/2009