Provider First Line Business Practice Location Address:
9500 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-3620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-587-8110
Provider Business Practice Location Address Fax Number:
661-587-8220
Provider Enumeration Date:
07/17/2006