Provider First Line Business Practice Location Address:
AGUADILLA MEDICAL PLAZA
Provider Second Line Business Practice Location Address:
CARR. #2 JOSE CANDELAS SUIT 203
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-766-4623
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/18/2006