Provider First Line Business Practice Location Address:
100 CALLIE JOSE C BARBOSA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAS PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00771-3927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-733-1404
Provider Business Practice Location Address Fax Number:
787-733-7788
Provider Enumeration Date:
12/22/2005