Provider First Line Business Practice Location Address:
2105 19TH 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:
93301-3708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-325-6300
Provider Business Practice Location Address Fax Number:
661-325-6302
Provider Enumeration Date:
04/20/2007