Provider First Line Business Practice Location Address:
2121 NILES ST
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:
93305-5007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-325-1255
Provider Business Practice Location Address Fax Number:
661-325-6417
Provider Enumeration Date:
09/08/2016