Provider First Line Business Practice Location Address:
1215 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:
93301-2107
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-2331
Provider Business Practice Location Address Fax Number:
661-322-1484
Provider Enumeration Date:
07/27/2006