Provider First Line Business Practice Location Address:
3820 WIBLE RD STE C
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:
93309-6714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-473-1440
Provider Business Practice Location Address Fax Number:
661-473-1442
Provider Enumeration Date:
07/30/2007