Provider First Line Business Practice Location Address:
1329 34TH 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:
93301-2109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-9411
Provider Business Practice Location Address Fax Number:
661-324-1561
Provider Enumeration Date:
08/04/2005