Provider First Line Business Practice Location Address:
3110 LATTE LANE
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:
93312-2141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-4712
Provider Business Practice Location Address Fax Number:
661-327-4004
Provider Enumeration Date:
07/07/2006