Provider First Line Business Practice Location Address:
715 N CHESTER AVE
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:
93308-3510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-399-5788
Provider Business Practice Location Address Fax Number:
661-399-4998
Provider Enumeration Date:
11/15/2005