Provider First Line Business Practice Location Address:
2007 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:
93301-4203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-633-1983
Provider Business Practice Location Address Fax Number:
661-633-1101
Provider Enumeration Date:
04/10/2006