Provider First Line Business Practice Location Address:
MAYOR ST 2651
Provider Second Line Business Practice Location Address:
DR JOSE A LIZASOGIN OFFICE
Provider Business Practice Location Address City Name:
PONCE
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00717-2072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-840-8383
Provider Business Practice Location Address Fax Number:
787-840-1582
Provider Enumeration Date:
02/21/2006