Provider First Line Business Practice Location Address:
9870 BRIMHALL RD UNIT 200
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:
93312-2798
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-637-1005
Provider Business Practice Location Address Fax Number:
661-637-1006
Provider Enumeration Date:
08/21/2007