Provider First Line Business Practice Location Address:
1925 17TH STREET
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:
93301-5012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-2295
Provider Business Practice Location Address Fax Number:
661-323-8040
Provider Enumeration Date:
06/08/2006