Provider First Line Business Practice Location Address:
1801 26TH 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:
93301-2805
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-8860
Provider Business Practice Location Address Fax Number:
661-322-8864
Provider Enumeration Date:
11/21/2006