Provider First Line Business Practice Location Address:
351 AVE HOSTOS CARR. 2
Provider Second Line Business Practice Location Address:
MEDICAL EMPORIUM SUITE 412
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00623
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-851-6965
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/13/2014