Provider First Line Business Practice Location Address:
HWY 101
Provider Second Line Business Practice Location Address:
CALIFORNIA DEPARTMENT OF CORRECTIONS AND REHABILITATION
Provider Business Practice Location Address City Name:
SOLEDAD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93960-0686
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-678-3951
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/27/2013