Provider First Line Business Practice Location Address:
1524 27TH ST STE 401
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:
93301-2056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-377-1411
Provider Business Practice Location Address Fax Number:
661-377-1415
Provider Enumeration Date:
09/13/2007