Provider First Line Business Practice Location Address:
3941 SAN DIMAS ST
Provider Second Line Business Practice Location Address:
SUITE 103B
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-5734
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-0403
Provider Business Practice Location Address Fax Number:
661-323-2950
Provider Enumeration Date:
06/30/2006