Provider First Line Business Practice Location Address:
1830 28TH 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:
93301-1904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-326-8536
Provider Business Practice Location Address Fax Number:
661-326-8511
Provider Enumeration Date:
10/26/2009