Provider First Line Business Practice Location Address:
1522 18TH ST
Provider Second Line Business Practice Location Address:
STE 210
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-4448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-5827
Provider Business Practice Location Address Fax Number:
661-395-0588
Provider Enumeration Date:
04/04/2007