Provider First Line Business Practice Location Address:
ROAD 21 T-3 #6 LAS LOMAS
Provider Second Line Business Practice Location Address:
FRENTE HOSPITAL METROPOLITANO ALTOS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-782-5125
Provider Business Practice Location Address Fax Number:
787-782-5125
Provider Enumeration Date:
05/24/2007