Provider First Line Business Practice Location Address:
3801 SAN DIMAS 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:
93301-5731
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-8477
Provider Business Practice Location Address Fax Number:
661-323-8472
Provider Enumeration Date:
10/12/2012