Provider First Line Business Practice Location Address:
1524 27TH ST
Provider Second Line Business Practice Location Address:
SUITE 405
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-2055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-4902
Provider Business Practice Location Address Fax Number:
661-322-4904
Provider Enumeration Date:
07/20/2006