Provider First Line Business Practice Location Address:
349 AVE HOSTOS
Provider Second Line Business Practice Location Address:
MEDICAL EMPORIUM II A-24
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680-1509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-834-7740
Provider Business Practice Location Address Fax Number:
787-652-4525
Provider Enumeration Date:
03/16/2007