Provider First Line Business Practice Location Address:
ARKANSAS VALLEY CORRECTIONAL FACILITY
Provider Second Line Business Practice Location Address:
12750 HIGHWAY 96 LANE 13
Provider Business Practice Location Address City Name:
CROWLEY
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
81034-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-267-5070
Provider Business Practice Location Address Fax Number:
719-267-5079
Provider Enumeration Date:
11/21/2006