Provider First Line Business Practice Location Address:
1509 E 11TH 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:
93307-1269
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-3276
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2008