Provider First Line Business Practice Location Address:
730 21ST 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:
93301-2913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-829-5930
Provider Business Practice Location Address Fax Number:
661-427-0386
Provider Enumeration Date:
11/10/2012