Provider First Line Business Practice Location Address:
4545 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
SUITE #
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:
661-835-1088
Provider Business Practice Location Address Fax Number:
661-835-1094
Provider Enumeration Date:
03/24/2006