Provider First Line Business Practice Location Address:
5500 MING AVE
Provider Second Line Business Practice Location Address:
SUITE 165
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-4689
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-835-8785
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2010