Provider First Line Business Practice Location Address:
2140 BRUNDAGE LANE
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:
93304-2702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-873-4742
Provider Business Practice Location Address Fax Number:
661-873-4734
Provider Enumeration Date:
11/09/2005