Provider First Line Business Practice Location Address:
1423 BERNARD 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:
93305-3946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-4756
Provider Business Practice Location Address Fax Number:
661-324-1652
Provider Enumeration Date:
04/24/2007