Provider First Line Business Practice Location Address:
ASHFORD MEDICAL CENTER
Provider Second Line Business Practice Location Address:
WASHINGTON #29 SUITE 504
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-724-0278
Provider Business Practice Location Address Fax Number:
787-724-0283
Provider Enumeration Date:
01/30/2007