Provider First Line Business Practice Location Address:
4374 E. BUTTE AVE AZ DEPT OF CORRECTIONS
Provider Second Line Business Practice Location Address:
SMUZ - BROWNING UNIT EYMAN COMPLEX
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-868-0201
Provider Business Practice Location Address Fax Number:
520-868-8573
Provider Enumeration Date:
09/07/2006