Provider First Line Business Practice Location Address:
6309 AMBERGROVE 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:
93313-4166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-487-7160
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/21/2011