Provider First Line Business Practice Location Address:
1005 CASINO 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:
93307-4307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-715-2670
Provider Business Practice Location Address Fax Number:
844-527-8535
Provider Enumeration Date:
12/01/2014