Provider First Line Business Practice Location Address:
CARR #2, RM 174, SUITE 101
Provider Second Line Business Practice Location Address:
SAN GERMAN MEDICAL PLAZA
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683-9339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-892-8585
Provider Business Practice Location Address Fax Number:
787-892-8585
Provider Enumeration Date:
03/08/2006