Provider First Line Business Practice Location Address:
CALZADA CETYS 2718 VEREDAS DEL SOL
Provider Second Line Business Practice Location Address:
PAZA 686 STE 16
Provider Business Practice Location Address City Name:
MEXICALI
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
21254
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
619-209-8924
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/16/2020