Provider First Line Business Practice Location Address:
4301 DE ETTE 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:
93313-2916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-827-9219
Provider Business Practice Location Address Fax Number:
661-827-9221
Provider Enumeration Date:
04/15/2015