Provider First Line Business Practice Location Address:
610 4TH 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:
93304-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-631-8415
Provider Business Practice Location Address Fax Number:
661-326-1602
Provider Enumeration Date:
04/23/2007