Provider First Line Business Practice Location Address:
2634 G ST
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:
93301-2814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-8121
Provider Business Practice Location Address Fax Number:
661-322-3547
Provider Enumeration Date:
06/14/2005