Provider First Line Business Practice Location Address:
ASSMCA SAN PATRICIO, EDIF 4
Provider Second Line Business Practice Location Address:
ANTIGUO HOSPITAL DE VETERANOS AVE. DE DIEGO
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00928-1414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-706-1866
Provider Business Practice Location Address Fax Number:
787-782-2282
Provider Enumeration Date:
04/23/2007