Provider First Line Business Practice Location Address:
200 CHINA GRADE LOOP
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:
93308-1735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-615-6150
Provider Business Practice Location Address Fax Number:
661-615-6151
Provider Enumeration Date:
08/16/2005