Provider First Line Business Practice Location Address:
3004 BELHAVEN 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:
93304-5509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-539-3684
Provider Business Practice Location Address Fax Number:
661-397-4213
Provider Enumeration Date:
11/02/2006