Provider First Line Business Practice Location Address:
2191 NILES 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:
93305-5168
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-4248
Provider Business Practice Location Address Fax Number:
661-327-1025
Provider Enumeration Date:
10/26/2005