Provider First Line Business Practice Location Address:
FOLSOM STATE PRISON
Provider Second Line Business Practice Location Address:
300 PRISON RD
Provider Business Practice Location Address City Name:
REPRESA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95671-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-985-2561
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2006