Provider First Line Business Practice Location Address:
BAYAMON MEDICAL MALL
Provider Second Line Business Practice Location Address:
1845 CARR #2 OFICINA 307
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00959-7200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-787-3535
Provider Business Practice Location Address Fax Number:
787-787-3550
Provider Enumeration Date:
11/05/2014