Provider First Line Business Practice Location Address:
3838 SAN DIMAS STREET, SUITE B100
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:
93301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-326-0552
Provider Business Practice Location Address Fax Number:
661-322-7609
Provider Enumeration Date:
10/03/2006