Provider First Line Business Practice Location Address:
9314 VIA LUGANO
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:
93312-6652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-310-1516
Provider Business Practice Location Address Fax Number:
501-639-7337
Provider Enumeration Date:
11/03/2008