Provider First Line Business Practice Location Address:
CARR #2 KM 174 SUITE 211
Provider Second Line Business Practice Location Address:
SAN GERMAN MEDICAL PLAZA
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-892-4590
Provider Business Practice Location Address Fax Number:
787-892-4595
Provider Enumeration Date:
07/12/2016