Provider First Line Business Practice Location Address:
1601 NEW STINE ROAD
Provider Second Line Business Practice Location Address:
SUITE 260
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-215-5066
Provider Business Practice Location Address Fax Number:
661-215-5066
Provider Enumeration Date:
02/23/2018