Provider First Line Business Practice Location Address:
CENTRO MEDICO
Provider Second Line Business Practice Location Address:
BO. MONACILLOS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-756-8535
Provider Business Practice Location Address Fax Number:
787-764-3643
Provider Enumeration Date:
08/28/2012