Provider First Line Business Practice Location Address:
6001 BLDG. A TRUXTUN AVENUE
Provider Second Line Business Practice Location Address:
STE. 180
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-8687
Provider Business Practice Location Address Fax Number:
661-325-4505
Provider Enumeration Date:
08/18/2006