Provider First Line Business Practice Location Address:
1500 S FAIRFAX RD
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:
93307-3151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-366-7221
Provider Business Practice Location Address Fax Number:
661-366-1901
Provider Enumeration Date:
12/27/2006