Provider First Line Business Practice Location Address:
1811 OAK ST UNIT 165B
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:
93301-3062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-348-4005
Provider Business Practice Location Address Fax Number:
661-348-4033
Provider Enumeration Date:
10/29/2014