Provider First Line Business Practice Location Address:
1603 CALIFORNIA AVE
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93304-1383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-204-1985
Provider Business Practice Location Address Fax Number:
661-670-5277
Provider Enumeration Date:
05/17/2010