Provider First Line Business Practice Location Address:
2302 COLUMBUS 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:
93306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-873-1111
Provider Business Practice Location Address Fax Number:
661-760-7946
Provider Enumeration Date:
01/21/2009