Provider First Line Business Practice Location Address:
1829 B ST APT 1
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:
93301-3538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-673-2235
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2009