Provider First Line Business Practice Location Address:
MEDICAL PSYCHIATRIC CENTER
Provider Second Line Business Practice Location Address:
MOLUCAS ST. 818 COUNTRY CLUB
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-768-0390
Provider Business Practice Location Address Fax Number:
787-768-1775
Provider Enumeration Date:
01/19/2006