Provider First Line Business Practice Location Address:
2116 24TH STREET
Provider Second Line Business Practice Location Address:
SUITE #4
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-3750
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-6553
Provider Business Practice Location Address Fax Number:
559-252-1781
Provider Enumeration Date:
04/06/2012