Provider First Line Business Practice Location Address:
PRIME OUTLETS, CARR #2 KM 54.6
Provider Second Line Business Practice Location Address:
CARIBBEAN CINEMAS SUITE 200
Provider Business Practice Location Address City Name:
BARCELONETA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-846-4645
Provider Business Practice Location Address Fax Number:
888-859-5656
Provider Enumeration Date:
11/07/2006