Provider First Line Business Practice Location Address:
4901 CENTENNIAL PLAZA WAY
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:
93312-2011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-387-8333
Provider Business Practice Location Address Fax Number:
661-241-4052
Provider Enumeration Date:
04/10/2007