Provider First Line Business Practice Location Address:
11527 PRIVET PL
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:
93311-9334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-664-8546
Provider Business Practice Location Address Fax Number:
661-664-8546
Provider Enumeration Date:
05/23/2008