Provider First Line Business Practice Location Address:
200 WALLACE DRIVE
Provider Second Line Business Practice Location Address:
EASTERLING CORRECTIONAL FACILITY (WEXFORD HEALTH)
Provider Business Practice Location Address City Name:
CLIO
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-397-4470
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/11/2019