Provider First Line Business Practice Location Address:
3812 COFFEE
Provider Second Line Business Practice Location Address:
C
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-588-5010
Provider Business Practice Location Address Fax Number:
661-588-5012
Provider Enumeration Date:
10/17/2013