Provider First Line Business Practice Location Address:
AVE REPUBLICA DE BRASIL #545 STE 1C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEXICALI
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
21200
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
664-252-6200
Provider Business Practice Location Address Fax Number:
619-908-1095
Provider Enumeration Date:
03/05/2021