Provider First Line Business Practice Location Address:
8200 N LAURELGLEN BLVD
Provider Second Line Business Practice Location Address:
APT 1503
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-2344
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-747-2140
Provider Business Practice Location Address Fax Number:
661-480-2560
Provider Enumeration Date:
06/03/2006