Provider First Line Business Practice Location Address:
10319 STONEHAM 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:
93314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-549-5699
Provider Business Practice Location Address Fax Number:
661-427-0220
Provider Enumeration Date:
03/05/2007