Provider First Line Business Practice Location Address:
501 J STREET, SUITE 530
Provider Second Line Business Practice Location Address:
CALIFORNIA DEPARTMENT OF CORRECTIONS & REHABILITATION
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-322-4344
Provider Business Practice Location Address Fax Number:
916-445-0601
Provider Enumeration Date:
11/16/2009