Provider First Line Business Practice Location Address:
2151 COLLEGE AVE
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-868-8036
Provider Business Practice Location Address Fax Number:
661-868-8018
Provider Enumeration Date:
11/23/2011