Provider First Line Business Practice Location Address:
10900 HARTLAND 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:
93312-7004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-912-2607
Provider Business Practice Location Address Fax Number:
661-589-7916
Provider Enumeration Date:
08/22/2013