Provider First Line Business Practice Location Address:
2701 16TH ST STE B
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:
93301-3352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-325-9466
Provider Business Practice Location Address Fax Number:
661-325-0706
Provider Enumeration Date:
08/16/2006