Provider First Line Business Practice Location Address:
CARR 125 KM 21.9 BO. BAHOMAMEY
Provider Second Line Business Practice Location Address:
SAN SEBASTIAN MEDICAL CENTER SUITE # 4
Provider Business Practice Location Address City Name:
SAN SEBASTIAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00685
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-926-7999
Provider Business Practice Location Address Fax Number:
787-926-7899
Provider Enumeration Date:
12/19/2012