Provider First Line Business Practice Location Address:
3535 SAN DIMAS STREET
Provider Second Line Business Practice Location Address:
SUITE 24
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93389
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-3128
Provider Business Practice Location Address Fax Number:
661-324-3130
Provider Enumeration Date:
06/26/2006