Provider First Line Business Practice Location Address:
6001 TRUXTUN AVE
Provider Second Line Business Practice Location Address:
SUITE 160
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:
661-323-6410
Provider Business Practice Location Address Fax Number:
661-323-7631
Provider Enumeration Date:
04/09/2007