Provider First Line Business Practice Location Address:
1800 MT VERNON AVENUE
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:
93306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-868-0402
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/29/2007