Provider First Line Business Practice Location Address:
2111 18TH STREET
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:
93301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-2113
Provider Business Practice Location Address Fax Number:
661-327-4549
Provider Enumeration Date:
12/05/2006