Provider First Line Business Practice Location Address:
8151 CALLE CONCORDIA
Provider Second Line Business Practice Location Address:
LABORATORIO CONCORDIA LUGARO
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00717-1552
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-852-3394
Provider Business Practice Location Address Fax Number:
787-852-3394
Provider Enumeration Date:
11/28/2005