Provider First Line Business Practice Location Address:
AV IGNACIO ALLENDE 7295 LOCAL-9
Provider Second Line Business Practice Location Address:
COL. INDEPENDENCIA
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
22055
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
663-428-8194
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2023