Provider First Line Business Practice Location Address:
6002 LAUSANNE ST
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:
93308-6589
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-703-6050
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/16/2012