Provider First Line Business Practice Location Address:
1851A OAK 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:
93301-3007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-7301
Provider Business Practice Location Address Fax Number:
661-327-9160
Provider Enumeration Date:
07/08/2005