Provider First Line Business Practice Location Address:
7701 PRISM WAY
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:
93313-5087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-303-1657
Provider Business Practice Location Address Fax Number:
661-885-6007
Provider Enumeration Date:
04/14/2010