Provider First Line Business Practice Location Address:
668 HERNANDEZ CARRION
Provider Second Line Business Practice Location Address:
MANATI MEDICAL CENTER SUITE 203
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:
787-918-0066
Provider Business Practice Location Address Fax Number:
787-621-4830
Provider Enumeration Date:
09/13/2011