Provider First Line Business Practice Location Address:
221 S MONTCLAIR 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:
93309-3165
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-241-5040
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/15/2008