Provider First Line Business Practice Location Address:
CALLE SOCIOLOGOS # 308
Provider Second Line Business Practice Location Address:
OTAY UNIVERSIDAD
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BAJA CALIFORNIA
Provider Business Practice Location Address Postal Code:
22427
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
664-381-1878
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2016