Provider First Line Business Practice Location Address:
3619 UNION AVE
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:
93305-2939
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-1248
Provider Business Practice Location Address Fax Number:
661-323-1399
Provider Enumeration Date:
10/14/2006