Provider First Line Business Practice Location Address:
65TH INFANTERIA
Provider Second Line Business Practice Location Address:
SAN JUAN AGING CENTER/COMPLEJO MEDICO SOCIAL ANTILLAS
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00983
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-767-7676
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2005