Provider First Line Business Practice Location Address:
4613 SAN MIGUEL WAY
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:
93306-2347
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-872-3028
Provider Business Practice Location Address Fax Number:
661-872-3028
Provider Enumeration Date:
11/16/2007