Provider First Line Business Practice Location Address:
3605 UNION AVE
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:
93305-2939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-2117
Provider Business Practice Location Address Fax Number:
661-322-2180
Provider Enumeration Date:
06/28/2005