Provider First Line Business Practice Location Address:
300 OLD RIVER RD STE 165B
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:
93311-9503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-665-2498
Provider Business Practice Location Address Fax Number:
661-381-7548
Provider Enumeration Date:
04/13/2012