Provider First Line Business Practice Location Address:
3535 SAN DIMAS ST STE 14
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:
93301-1694
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-522-0043
Provider Business Practice Location Address Fax Number:
661-871-1413
Provider Enumeration Date:
07/20/2009