Provider First Line Business Practice Location Address:
PAVIA MEDICAL PLAZA 611 SUITE 214
Provider Second Line Business Practice Location Address:
CALLE MANUEL PAVIA
Provider Business Practice Location Address City Name:
SANTURCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-726-7008
Provider Business Practice Location Address Fax Number:
787-726-7083
Provider Enumeration Date:
07/09/2006