Provider First Line Business Practice Location Address:
2100 19TH ST STE C
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:
93301-3719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-246-4026
Provider Business Practice Location Address Fax Number:
661-246-4020
Provider Enumeration Date:
05/10/2006