Provider First Line Business Practice Location Address:
13 BLISS ST
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:
93307-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-472-0365
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2011