Provider First Line Business Practice Location Address:
2631 FASHION PL STE A
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:
93306-3067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-871-2223
Provider Business Practice Location Address Fax Number:
661-871-0764
Provider Enumeration Date:
10/22/2009