Provider First Line Business Practice Location Address:
4550 COFFEE RD
Provider Second Line Business Practice Location Address:
SUITE H
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93308-5023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-587-0700
Provider Business Practice Location Address Fax Number:
661-587-9131
Provider Enumeration Date:
09/20/2006