Provider First Line Business Practice Location Address:
LAWTEY CORRECTIONAL INSTITUTION
Provider Second Line Business Practice Location Address:
7819 NW 228 ST.
Provider Business Practice Location Address City Name:
RAIFORD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32026-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
904-782-2318
Provider Business Practice Location Address Fax Number:
904-782-2011
Provider Enumeration Date:
11/25/2013