Provider First Line Business Practice Location Address:
3204 21ST 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:
93301-3117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-412-9730
Provider Business Practice Location Address Fax Number:
661-412-9731
Provider Enumeration Date:
11/30/2012