Provider First Line Business Practice Location Address:
6401 WHITE LANE
Provider Second Line Business Practice Location Address:
#107
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-396-7740
Provider Business Practice Location Address Fax Number:
661-396-7748
Provider Enumeration Date:
12/14/2006