Provider First Line Business Practice Location Address:
PR2, HOSPITAL DOCTORS' CENTER
Provider Second Line Business Practice Location Address:
SUITE 201-202, TORRE DOCTORS' CENTER
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-1152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-7545
Provider Business Practice Location Address Fax Number:
787-854-6890
Provider Enumeration Date:
05/27/2005