Provider First Line Business Practice Location Address:
1999 EDISON HWY
Provider Second Line Business Practice Location Address:
SUITES 2,4, 6
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93305-5554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-861-9266
Provider Business Practice Location Address Fax Number:
661-861-9222
Provider Enumeration Date:
05/31/2005