Provider First Line Business Practice Location Address:
1415 18TH ST
Provider Second Line Business Practice Location Address:
#522
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-4430
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-325-2732
Provider Business Practice Location Address Fax Number:
661-325-2101
Provider Enumeration Date:
06/04/2007