Provider First Line Business Practice Location Address:
4040 SAN DIMAS 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:
93301-1298
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-3787
Provider Business Practice Location Address Fax Number:
661-327-0164
Provider Enumeration Date:
03/15/2007