Provider First Line Business Practice Location Address:
3723 WILSON RD
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:
93309-5141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-834-4334
Provider Business Practice Location Address Fax Number:
661-834-5885
Provider Enumeration Date:
11/07/2005