Provider First Line Business Practice Location Address:
3301 19TH ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-3066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-2051
Provider Business Practice Location Address Fax Number:
661-633-1730
Provider Enumeration Date:
10/11/2005