Provider First Line Business Practice Location Address:
3401 CHESTER AVE STE J
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:
93301-1640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-873-1600
Provider Business Practice Location Address Fax Number:
661-861-1143
Provider Enumeration Date:
11/15/2006