Provider First Line Business Practice Location Address:
2611 G 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:
93301-2813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-859-0192
Provider Business Practice Location Address Fax Number:
661-859-0191
Provider Enumeration Date:
02/20/2007