Provider First Line Business Practice Location Address:
4022 NILES ST # B
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:
93306-4630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-871-3736
Provider Business Practice Location Address Fax Number:
661-871-7417
Provider Enumeration Date:
12/12/2006