Provider First Line Business Practice Location Address:
AVE HOSTOS
Provider Second Line Business Practice Location Address:
CLINICA DE INMUNOLOGIA (CPTET)
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00682-6353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-834-2118
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2006