Provider First Line Business Practice Location Address:
CALLE FONT MARTELO 128
Provider Second Line Business Practice Location Address:
CLINICA DEL ESTE
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-850-4515
Provider Business Practice Location Address Fax Number:
787-850-4515
Provider Enumeration Date:
01/29/2007