Provider First Line Business Practice Location Address:
AVE. BATANCES J-23 URB. HERMANAS DAVILA
Provider Second Line Business Practice Location Address:
BAYAMON MEDICAL MALL
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-5350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-778-5311
Provider Business Practice Location Address Fax Number:
787-778-5302
Provider Enumeration Date:
05/04/2006