Provider First Line Business Practice Location Address:
5215 ASHE RD
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:
93313-2069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-872-3408
Provider Business Practice Location Address Fax Number:
661-872-5150
Provider Enumeration Date:
01/30/2007