Provider First Line Business Practice Location Address:
1524 27TH ST
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-2055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-5976
Provider Business Practice Location Address Fax Number:
666-323-7748
Provider Enumeration Date:
07/22/2006