Provider First Line Business Practice Location Address:
1002 CALLOWAY DR
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:
93312-6337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-588-4286
Provider Business Practice Location Address Fax Number:
661-588-9986
Provider Enumeration Date:
02/27/2007