Provider First Line Business Practice Location Address:
9900 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
SUITE 209
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311-3632
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-617-3081
Provider Business Practice Location Address Fax Number:
661-617-3088
Provider Enumeration Date:
08/21/2007