Provider First Line Business Practice Location Address:
LEGACY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
SUITE #13
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-222-9952
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2007