Provider First Line Business Practice Location Address:
1001 21ST 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:
93301-4792
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-8741
Provider Business Practice Location Address Fax Number:
661-334-1541
Provider Enumeration Date:
08/13/2006