Provider First Line Business Practice Location Address:
4500 TRADE CENTER DR
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-8716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-836-5521
Provider Business Practice Location Address Fax Number:
661-836-5808
Provider Enumeration Date:
09/01/2016