Provider First Line Business Practice Location Address:
4450 COFFEE RD
Provider Second Line Business Practice Location Address:
2A
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93308-5032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-679-6997
Provider Business Practice Location Address Fax Number:
661-679-6998
Provider Enumeration Date:
04/06/2007