Provider First Line Business Practice Location Address:
2201 19TH 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:
93301-3608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-631-9455
Provider Business Practice Location Address Fax Number:
661-631-9454
Provider Enumeration Date:
04/18/2008