Provider First Line Business Practice Location Address:
URB SANTA RITA MARGINAL 1
Provider Second Line Business Practice Location Address:
CARIBE MEDICAL PLAZA #207
Provider Business Practice Location Address City Name:
VEGA ALTA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-915-0906
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/04/2007