Provider First Line Business Practice Location Address:
3535 SAN DIMAS STREET
Provider Second Line Business Practice Location Address:
SUITE 12
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-1695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-444-0871
Provider Business Practice Location Address Fax Number:
661-427-0240
Provider Enumeration Date:
09/07/2012