Provider First Line Business Practice Location Address:
1927 21ST 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:
93301-4217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-4431
Provider Business Practice Location Address Fax Number:
661-324-5616
Provider Enumeration Date:
05/16/2007