Provider First Line Business Practice Location Address:
PRISON RD
Provider Second Line Business Practice Location Address:
CALIFORNIA STATE PRISON SACRAMENTO
Provider Business Practice Location Address City Name:
REPRESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95670
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-324-6317
Provider Business Practice Location Address Fax Number:
916-294-3195
Provider Enumeration Date:
05/07/2008