Provider First Line Business Practice Location Address:
1705 CHERRY 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:
93304-2001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-1678
Provider Business Practice Location Address Fax Number:
661-327-2832
Provider Enumeration Date:
06/26/2006