Provider First Line Business Practice Location Address:
300 17TH ST
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:
93301-4916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-869-1982
Provider Business Practice Location Address Fax Number:
661-243-8710
Provider Enumeration Date:
09/22/2006