Provider First Line Business Practice Location Address:
200 S MONTCLAIR ST STE C
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:
93309-3110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-342-6777
Provider Business Practice Location Address Fax Number:
661-847-9559
Provider Enumeration Date:
02/12/2009