Provider First Line Business Practice Location Address:
14015 SANTA FE CT
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:
93314-8357
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-747-3236
Provider Business Practice Location Address Fax Number:
661-588-4242
Provider Enumeration Date:
08/22/2009