Provider First Line Business Practice Location Address:
2320 17TH 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:
93301-3504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-350-7412
Provider Business Practice Location Address Fax Number:
866-740-3352
Provider Enumeration Date:
05/20/2007