Provider First Line Business Practice Location Address:
EDIFICION PROFESSIONAL, 301 HOSPITAL MEMOMITA
Provider Second Line Business Practice Location Address:
CALLE JOSE SABASTIAN
Provider Business Practice Location Address City Name:
AIBONITO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00705-2056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-735-7500
Provider Business Practice Location Address Fax Number:
787-735-7500
Provider Enumeration Date:
07/15/2005