Provider First Line Business Practice Location Address:
ASHFORD MEDICAL CTR
Provider Second Line Business Practice Location Address:
WASHINGTON ST. # 29 SUITE 806
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00907-1510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-725-8533
Provider Business Practice Location Address Fax Number:
787-725-8533
Provider Enumeration Date:
05/18/2006