Provider First Line Business Practice Location Address:
5809 INDIAN WELLS 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:
93309-3572
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-6090
Provider Business Practice Location Address Fax Number:
661-396-0596
Provider Enumeration Date:
05/14/2007