Provider First Line Business Practice Location Address:
8305 BRIMHALL RD
Provider Second Line Business Practice Location Address:
STE 1601
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93312-2243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-853-6738
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/29/2011