Provider First Line Business Practice Location Address:
4698 AMERICAN AVE
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-4007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-834-5660
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2006