Provider First Line Business Practice Location Address:
2021 22ND 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:
93301-3802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-864-7076
Provider Business Practice Location Address Fax Number:
661-864-7131
Provider Enumeration Date:
07/29/2005