Provider First Line Business Practice Location Address:
150 AVE DE DIEGO STE 604
Provider Second Line Business Practice Location Address:
SAN JUAN HEALTH CENTRE
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907-2318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-723-2023
Provider Business Practice Location Address Fax Number:
787-723-2021
Provider Enumeration Date:
07/17/2006