Provider First Line Business Practice Location Address:
1500 BAKER ST UNIT C
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:
93305-3771
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-717-3521
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2008