Provider First Line Business Practice Location Address:
CARCEL REGIONAL DE BAYAMON
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-786-0016
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/30/2007