Provider First Line Business Practice Location Address:
1509 E. 11TH 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:
93307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-3276
Provider Business Practice Location Address Fax Number:
661-323-6259
Provider Enumeration Date:
03/07/2008