Provider First Line Business Practice Location Address:
13251 -F7 DIAZ ORDAZ BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TIJUANA
Provider Business Practice Location Address State Name:
BC
Provider Business Practice Location Address Postal Code:
22000
Provider Business Practice Location Address Country Code:
MX
Provider Business Practice Location Address Telephone Number:
664-621-1278
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/28/2011