Provider First Line Business Practice Location Address:
2009 MOUNTAIN OAK 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:
93311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-664-9687
Provider Business Practice Location Address Fax Number:
661-664-9687
Provider Enumeration Date:
05/07/2012