Provider First Line Business Practice Location Address:
4101 EMPIRE DR
Provider Second Line Business Practice Location Address:
#130
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-325-1900
Provider Business Practice Location Address Fax Number:
661-335-7755
Provider Enumeration Date:
12/27/2005