Provider First Line Business Practice Location Address:
9602 STOCKDALE HWY
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:
93311-3618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-599-3169
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/04/2010