Provider First Line Business Practice Location Address:
2601 FASHION PL
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:
93306-3027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-871-8201
Provider Business Practice Location Address Fax Number:
661-871-8395
Provider Enumeration Date:
11/06/2007