Provider First Line Business Practice Location Address:
1 CALLE JOSE D CANDELAS
Provider Second Line Business Practice Location Address:
MANATI MEDICAL PLAZA SUITE 105
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674-5507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-884-5635
Provider Business Practice Location Address Fax Number:
787-884-7462
Provider Enumeration Date:
01/28/2007