Provider First Line Business Practice Location Address:
NINTH FLOOR OFFICE 954
Provider Second Line Business Practice Location Address:
UPR MEDICAL SCIENCES CAMPUS MAIN BUILDING
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-758-2525
Provider Business Practice Location Address Fax Number:
787-766-0940
Provider Enumeration Date:
02/06/2007