Provider First Line Business Practice Location Address:
2119 17TH 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:
93301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-616-5726
Provider Business Practice Location Address Fax Number:
661-664-0188
Provider Enumeration Date:
01/08/2013