Provider First Line Business Practice Location Address:
1524 27TH ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-2055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-3101
Provider Business Practice Location Address Fax Number:
661-327-3258
Provider Enumeration Date:
04/24/2009