Provider First Line Business Practice Location Address:
110 S MONTCLAIR ST
Provider Second Line Business Practice Location Address:
STE 205
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-3111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-237-5569
Provider Business Practice Location Address Fax Number:
661-835-6326
Provider Enumeration Date:
04/16/2013