Provider First Line Business Practice Location Address:
2225 E ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-3837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-377-0180
Provider Business Practice Location Address Fax Number:
661-377-0185
Provider Enumeration Date:
09/29/2005