Provider First Line Business Practice Location Address:
SAN GERMAN MEDICAL PLAZA #208
Provider Second Line Business Practice Location Address:
CARR. #2 KM. 174.0
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-264-3125
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/25/2007