Provider First Line Business Practice Location Address:
1921 18TH 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:
93301-4205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-9693
Provider Business Practice Location Address Fax Number:
661-864-7711
Provider Enumeration Date:
11/12/2006