Provider First Line Business Practice Location Address:
9610 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-3625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-496-0887
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/25/2016