Provider First Line Business Practice Location Address:
1717 MING AVENUE
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-831-4050
Provider Business Practice Location Address Fax Number:
661-831-9425
Provider Enumeration Date:
11/16/2006