Provider First Line Business Practice Location Address:
100 US HIGHWAY 40
Provider Second Line Business Practice Location Address:
FCI GREENVILLE, FEDERAL BUREAU OF PRISONS
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62246
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-531-6397
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/18/2017