Provider First Line Business Practice Location Address:
420 34TH 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:
93301-2237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
613-274-6476
Provider Business Practice Location Address Fax Number:
661-327-1998
Provider Enumeration Date:
08/24/2006