Provider First Line Business Practice Location Address:
3838 SAN DIMAS ST
Provider Second Line Business Practice Location Address:
BUILDING B SUITE 111
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-2284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-616-1030
Provider Business Practice Location Address Fax Number:
661-716-5484
Provider Enumeration Date:
09/21/2006