Provider First Line Business Practice Location Address:
1412 17TH ST
Provider Second Line Business Practice Location Address:
SUITE 219
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-5211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-303-2451
Provider Business Practice Location Address Fax Number:
661-393-0349
Provider Enumeration Date:
03/27/2007