Provider First Line Business Practice Location Address:
CASIA ST 10 VA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
RADIOLOGY SERVICE 114
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:
787-758-7575
Provider Business Practice Location Address Fax Number:
787-641-2965
Provider Enumeration Date:
04/18/2006