Provider First Line Business Practice Location Address:
307 S CHESTER AVE
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:
93304-3650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-874-3668
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/28/2008