Provider First Line Business Practice Location Address:
230 S MONTCLAIR ST
Provider Second Line Business Practice Location Address:
SUITE101
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-3117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-326-8035
Provider Business Practice Location Address Fax Number:
661-326-8037
Provider Enumeration Date:
03/14/2007