Provider First Line Business Practice Location Address:
1801 16TH ST # A
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:
93301-5002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
660-326-8989
Provider Business Practice Location Address Fax Number:
661-326-8991
Provider Enumeration Date:
10/17/2006