Provider First Line Business Practice Location Address:
3316 LAVERNE AVE
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:
93309-4082
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-832-8504
Provider Business Practice Location Address Fax Number:
661-827-9432
Provider Enumeration Date:
02/22/2007