Provider First Line Business Practice Location Address:
5620 STOCKDALE HWY
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:
93309-2570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-326-8848
Provider Business Practice Location Address Fax Number:
661-326-8019
Provider Enumeration Date:
07/28/2007