Provider First Line Business Practice Location Address:
2711 SUGAR 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:
93314-5201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-837-2199
Provider Business Practice Location Address Fax Number:
661-837-1262
Provider Enumeration Date:
06/30/2011