Provider First Line Business Practice Location Address:
1830 FLOWER 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:
93305-4144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-326-2767
Provider Business Practice Location Address Fax Number:
661-862-7672
Provider Enumeration Date:
08/26/2005