Provider First Line Business Practice Location Address:
5300 LENNOX AVE
Provider Second Line Business Practice Location Address:
SUITE NUMBER 302
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-1662
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-852-0712
Provider Business Practice Location Address Fax Number:
661-852-0722
Provider Enumeration Date:
10/25/2006