Provider First Line Business Practice Location Address:
RIVERS STATE PRISON
Provider Second Line Business Practice Location Address:
MEDICAL DEPARTMENT
Provider Business Practice Location Address City Name:
HARDWICK
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31034-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-445-6774
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/21/2007