Provider First Line Business Practice Location Address:
9500 STOCKDALE HWY STE 103
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:
93311-3621
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-6593
Provider Business Practice Location Address Fax Number:
661-200-0145
Provider Enumeration Date:
10/28/2006