Provider First Line Business Practice Location Address:
2323 16TH ST STE 203
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:
93301-3453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-395-1234
Provider Business Practice Location Address Fax Number:
661-395-1292
Provider Enumeration Date:
12/13/2010