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:
93305-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
180-099-1527
Provider Business Practice Location Address Fax Number:
166-286-8807
Provider Enumeration Date:
03/15/2007