Provider First Line Business Practice Location Address:
608 34TH 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:
93301-2208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-845-3731
Provider Business Practice Location Address Fax Number:
661-845-1157
Provider Enumeration Date:
08/17/2006