Provider First Line Business Practice Location Address:
CARR 159 ORITZ MEDICAL PLAZA
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
COROZAL
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-600-6953
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/24/2015