Provider First Line Business Practice Location Address:
CLINICA BORINQUEN SUITE 106
Provider Second Line Business Practice Location Address:
AVE CAMPO RICO
Provider Business Practice Location Address City Name:
CAROLINA
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00982
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-762-9409
Provider Business Practice Location Address Fax Number:
787-701-1134
Provider Enumeration Date:
03/28/2006