Provider First Line Business Practice Location Address:
CASIA ST #10
Provider Second Line Business Practice Location Address:
VA CARIBBEAN HEALTHCARE SYSTEM
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00927-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-319-5796
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2006