Provider First Line Business Practice Location Address:
420 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:
93301-2237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-4647
Provider Business Practice Location Address Fax Number:
661-395-0965
Provider Enumeration Date:
09/09/2014