Provider First Line Business Practice Location Address:
8200 STOCKDALE HWY STE M10-173
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:
93311-1091
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-632-6963
Provider Business Practice Location Address Fax Number:
661-864-1105
Provider Enumeration Date:
01/30/2006