Provider First Line Business Practice Location Address:
3838 SAN DIMAS ST STE A100
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:
93301-2286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-4963
Provider Business Practice Location Address Fax Number:
661-327-5432
Provider Enumeration Date:
07/14/2006