Provider First Line Business Practice Location Address:
3500 TRUXTUN AVENUE
Provider Second Line Business Practice Location Address:
SUITE A, SUITE B
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93301-3018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-7668
Provider Business Practice Location Address Fax Number:
661-407-8380
Provider Enumeration Date:
07/27/2007