Provider First Line Business Practice Location Address:
1420 H STREET
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-868-7660
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/15/2012