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1043746860
GENNIFER COSTALES
AGUADILLA, PUERTO RICO
NPI
1043746860
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Former Name
GENNIFER WATSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171000000X Military Health Care Provider
Enumeration Date
2017-05-11
Last Update Date
2017-05-11
Business Address
GENNIFER COSTALES
75 HOOD RD
AGUADILLA, PUERTO RICO 00603
Phone number: 787-890-8477
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Mailing Address
GENNIFER COSTALES
75 HOOD RD
AGUADILLA, PR 00603
Phone number: 787-890-8477
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