Provider First Line Business Practice Location Address:
3809 SAN DIMAS 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:
93301-5726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
714-623-9282
Provider Business Practice Location Address Fax Number:
661-664-0928
Provider Enumeration Date:
08/14/2007