Provider First Line Business Practice Location Address:
AVENIDA SEVERIANO CUEVAS #18 INT
Provider Second Line Business Practice Location Address:
HOSPITAL BUEN SAMARITANO LOBBY
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-208-6009
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2018