Provider First Line Business Practice Location Address:
414 AVE BARBOSA
Provider Second Line Business Practice Location Address:
BAYAMON METHADONE CENTER
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00917-4306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-787-4464
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2007