Provider First Line Business Practice Location Address:
DEPT. OF HEALTH SEVERIANO CUEVAS AVE
Provider Second Line Business Practice Location Address:
APARTMENT #3
Provider Business Practice Location Address City Name:
AGUADILLA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-891-8600
Provider Business Practice Location Address Fax Number:
787-819-0285
Provider Enumeration Date:
06/21/2007