Provider First Line Business Practice Location Address:
12 MUNOZ RIVERA ST
Provider Second Line Business Practice Location Address:
LA FE PHARMACY
Provider Business Practice Location Address City Name:
TRUJILLO ALTO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-761-0210
Provider Business Practice Location Address Fax Number:
787-761-5582
Provider Enumeration Date:
10/26/2007