Provider First Line Business Practice Location Address:
CARR. 2 KM 174
Provider Second Line Business Practice Location Address:
SAN GERMAN MEDICAL PLAZA SUITE 204
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-529-8125
Provider Business Practice Location Address Fax Number:
787-892-0588
Provider Enumeration Date:
09/10/2009