Provider First Line Business Practice Location Address:
1100 UNION AVE
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:
93307-1051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-861-6111
Provider Business Practice Location Address Fax Number:
661-861-6161
Provider Enumeration Date:
05/30/2012