Provider First Line Business Practice Location Address:
1805 28TH 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:
93301-1903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-325-5751
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/28/2013