Provider First Line Business Practice Location Address:
CALLE PERIFERAL ED. A PABELLON 2
Provider Second Line Business Practice Location Address:
TERRENOS DE CENTRO MEDICO
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:
787-274-5553
Provider Business Practice Location Address Fax Number:
787-274-5554
Provider Enumeration Date:
10/25/2006