Provider First Line Business Practice Location Address:
9802 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-3652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-1200
Provider Business Practice Location Address Fax Number:
661-616-5339
Provider Enumeration Date:
12/29/2005