Provider First Line Business Practice Location Address:
2216A CALLE TERCERA
Provider Second Line Business Practice Location Address:
ZONA CENTRO
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BC
Provider Business Practice Location Address Postal Code:
22000
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
011526643880736
Provider Business Practice Location Address Fax Number:
664-685-1991
Provider Enumeration Date:
11/27/2006