Provider First Line Business Practice Location Address:
4101 EMPIRE DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-6511
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/16/2006