Provider First Line Business Practice Location Address:
1701 26TH 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:
93301-2803
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-843-7880
Provider Business Practice Location Address Fax Number:
661-843-7882
Provider Enumeration Date:
12/31/2013