Provider First Line Business Practice Location Address:
609 4TH STREET
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:
93304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-631-3205
Provider Business Practice Location Address Fax Number:
661-328-0591
Provider Enumeration Date:
10/03/2006