Provider First Line Business Practice Location Address:
WASCO STATE PRISON
Provider Second Line Business Practice Location Address:
701 SCOFIELD AVE
Provider Business Practice Location Address City Name:
WASCO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93280-8800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-758-8400
Provider Business Practice Location Address Fax Number:
661-758-7619
Provider Enumeration Date:
07/02/2007