Provider First Line Business Practice Location Address:
1401 COMMERCIAL WAY
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-859-5100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/17/2011