Provider First Line Business Practice Location Address:
2222 19TH STREET
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:
93301-3609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-328-0800
Provider Business Practice Location Address Fax Number:
661-325-7425
Provider Enumeration Date:
01/29/2008