Provider First Line Business Practice Location Address:
2010 17TH 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:
661-871-3514
Provider Business Practice Location Address Fax Number:
661-325-7199
Provider Enumeration Date:
10/27/2006