Provider First Line Business Practice Location Address:
2618 KST
Provider Second Line Business Practice Location Address:
#C
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-3908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-634-9141
Provider Business Practice Location Address Fax Number:
661-634-0144
Provider Enumeration Date:
09/19/2007