Provider First Line Business Practice Location Address:
APS HEALTHCARE PUERTO RICO NO. 2 CHARDON AVENUE
Provider Second Line Business Practice Location Address:
SUITE 200A
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918-8574
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-641-0773
Provider Business Practice Location Address Fax Number:
787-641-0794
Provider Enumeration Date:
01/13/2011