Provider First Line Business Practice Location Address:
ASHFORD AVE 29 WASHINGTON
Provider Second Line Business Practice Location Address:
ASHFORD MEDICAL CENTER STE 403
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907-1521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-721-6883
Provider Business Practice Location Address Fax Number:
787-723-3808
Provider Enumeration Date:
05/02/2006