Provider First Line Business Practice Location Address:
2525 EYE ST
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-2064
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-637-0137
Provider Business Practice Location Address Fax Number:
661-637-0177
Provider Enumeration Date:
08/09/2006