Provider First Line Business Practice Location Address:
CALLE CANADAS 1324
Provider Second Line Business Practice Location Address:
CENTRO SALUD MENTAL SAN PATRICIO
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00921-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-793-1550
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/18/2009