Provider First Line Business Practice Location Address:
8625 LIBERTY PARK DRIVE, SUITE 101
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:
93311-1374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-2263
Provider Business Practice Location Address Fax Number:
661-322-6250
Provider Enumeration Date:
09/25/2006