Provider First Line Business Practice Location Address:
1518 NILES STREET
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:
93305-4806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-326-0766
Provider Business Practice Location Address Fax Number:
661-326-6482
Provider Enumeration Date:
02/09/2007