Provider First Line Business Practice Location Address:
21 N1324
Provider Second Line Business Practice Location Address:
APT. 21
Provider Business Practice Location Address City Name:
LA PLATA
Provider Business Practice Location Address State Name:
BUENOS AIRES
Provider Business Practice Location Address Postal Code:
19000
Provider Business Practice Location Address Country Code:
AR
Provider Business Practice Location Address Telephone Number:
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/02/2026