Provider First Line Business Practice Location Address:
1909 16TH ST STE 6
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:
93301-5004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-475-8228
Provider Business Practice Location Address Fax Number:
661-215-0950
Provider Enumeration Date:
12/02/2010