Provider First Line Business Practice Location Address:
804 18TH 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:
93301-4824
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-3081
Provider Business Practice Location Address Fax Number:
661-323-0422
Provider Enumeration Date:
08/23/2006