Provider First Line Business Practice Location Address:
CALZADA MA CRISTY DE HERMOSILLO #86
Provider Second Line Business Practice Location Address:
COL. REPUBLICA MEDICANA
Provider Business Practice Location Address City Name:
MEXICALI
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
21250
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
011526865540094
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2016