Provider First Line Business Practice Location Address:
MANATI MEDICAL PLAZA, SUITE 107-108, SECTOR LA LOMITA
Provider Second Line Business Practice Location Address:
#1 CALLE JOSE CANDELAS
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-1150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-1313
Provider Business Practice Location Address Fax Number:
787-884-5320
Provider Enumeration Date:
05/14/2007