Provider First Line Business Practice Location Address:
CALLE BETANCES 155
Provider Second Line Business Practice Location Address:
BOX 713 FARMACIA SAN JOSE
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-1035
Provider Business Practice Location Address Fax Number:
787-878-1035
Provider Enumeration Date:
03/02/2007