Provider First Line Business Practice Location Address:
110 NEW STINE RD
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:
93309-2605
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-832-1666
Provider Business Practice Location Address Fax Number:
661-832-2039
Provider Enumeration Date:
09/16/2006