Provider First Line Business Practice Location Address:
J. CANDELA ST. #1
Provider Second Line Business Practice Location Address:
STE.106 MANATI MEDICAL PLAZA
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-884-3907
Provider Business Practice Location Address Fax Number:
787-884-0905
Provider Enumeration Date:
02/14/2006