Provider First Line Business Practice Location Address:
ASHFORD MEDICAL CENTER 29 WASHINGTON
Provider Second Line Business Practice Location Address:
SUITE 809
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:
787-723-6225
Provider Business Practice Location Address Fax Number:
787-721-7639
Provider Enumeration Date:
01/26/2007