Provider First Line Business Practice Location Address:
3838 SAN DIMAS ST STE B201
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:
93301-1496
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-321-3161
Provider Business Practice Location Address Fax Number:
661-321-3166
Provider Enumeration Date:
08/22/2007