Provider First Line Business Practice Location Address:
7501 SCARLET RIVER DR APT J
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:
93308-7531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-590-8170
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2012