Provider First Line Business Practice Location Address:
1405 NILES 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:
93305-4731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-9317
Provider Business Practice Location Address Fax Number:
661-327-8214
Provider Enumeration Date:
08/10/2006