Provider First Line Business Practice Location Address:
BLVD. DIAZ ORDAZ #12588
Provider Second Line Business Practice Location Address:
FRACC EL PRADO
Provider Business Practice Location Address City Name:
TUJUANA
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
22105
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
011526646080840
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/22/2016