Provider First Line Business Practice Location Address:
1800 MOUNT VERNON 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:
93306-3302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-824-7126
Provider Business Practice Location Address Fax Number:
661-824-7031
Provider Enumeration Date:
12/11/2007