Provider First Line Business Practice Location Address:
217 MT. VERNON AVE #3
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-321-9023
Provider Business Practice Location Address Fax Number:
661-321-9083
Provider Enumeration Date:
05/24/2011