Provider First Line Business Practice Location Address:
2303 17TH 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:
93301-3503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-1931
Provider Business Practice Location Address Fax Number:
661-322-4349
Provider Enumeration Date:
05/09/2006