Provider First Line Business Practice Location Address:
3817 EDITH LN
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:
93304-6703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-834-7789
Provider Business Practice Location Address Fax Number:
661-834-2340
Provider Enumeration Date:
03/02/2007