Provider First Line Business Practice Location Address:
1101 UNION AVE # 100
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:
93307-1050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-631-1483
Provider Business Practice Location Address Fax Number:
661-631-8665
Provider Enumeration Date:
01/31/2011