Provider First Line Business Practice Location Address:
2008 D 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:
93301-3726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-634-9877
Provider Business Practice Location Address Fax Number:
661-864-0198
Provider Enumeration Date:
02/27/2007