Provider First Line Business Practice Location Address:
VA MEDICAL CENTER CALLE CASIA 10
Provider Second Line Business Practice Location Address:
DEPARTMENT OF VETERAN AFFAIRS
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921-3201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-881-0102
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2010