Provider First Line Business Practice Location Address:
215 CHINA GRADE LOOP
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:
93308-1707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-393-2331
Provider Business Practice Location Address Fax Number:
661-393-6284
Provider Enumeration Date:
09/02/2005