Provider First Line Business Practice Location Address:
JOSE RODRIGUEZ IRIZARRY #152
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARECIBO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00612-4625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-878-1548
Provider Business Practice Location Address Fax Number:
787-880-0832
Provider Enumeration Date:
11/01/2011