Provider First Line Business Practice Location Address:
2001 OLD FARM RD
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:
93312-3521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-410-8125
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/28/2006