Provider First Line Business Practice Location Address:
5500 MING AVE
Provider Second Line Business Practice Location Address:
228
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-4689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-397-4777
Provider Business Practice Location Address Fax Number:
661-397-4277
Provider Enumeration Date:
09/14/2012