Provider First Line Business Practice Location Address:
2215 G STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-3931
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-1312
Provider Business Practice Location Address Fax Number:
661-324-0901
Provider Enumeration Date:
11/09/2006