Provider First Line Business Practice Location Address:
10 PISO EDIF
Provider Second Line Business Practice Location Address:
FARMACIA CENTUO MEDICO
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00936-8344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-773-8283
Provider Business Practice Location Address Fax Number:
787-773-8303
Provider Enumeration Date:
05/21/2007