Provider First Line Business Practice Location Address:
COMPLEJO CORRECIONAL BAYAMON
Provider Second Line Business Practice Location Address:
AVE. CENTRAL JUANITA FINAL
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-778-5858
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2007