Provider First Line Business Practice Location Address:
100 OLD RIVER RD STE 110
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:
93311-8334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-371-2790
Provider Business Practice Location Address Fax Number:
661-716-4799
Provider Enumeration Date:
07/30/2007