Provider First Line Business Practice Location Address:
1209 COLUMBUS 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:
93305-2009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-872-2672
Provider Business Practice Location Address Fax Number:
661-872-1982
Provider Enumeration Date:
04/19/2007