Provider First Line Business Practice Location Address:
LEGACY MEDICAL CENTER
Provider Second Line Business Practice Location Address:
12 CALLE VICTORIA SUITE 22
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00971-4293
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-266-9151
Provider Business Practice Location Address Fax Number:
787-520-7419
Provider Enumeration Date:
11/09/2022