Provider First Line Business Practice Location Address:
1227 CHESTER AVE
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:
93301-5445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-410-4000
Provider Business Practice Location Address Fax Number:
559-542-8308
Provider Enumeration Date:
11/07/2005