Provider First Line Business Practice Location Address:
2811 H 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:
93301-1913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-325-0700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2007