Provider First Line Business Practice Location Address:
6001 TRUXTUN AVE # A
Provider Second Line Business Practice Location Address:
SUITE 180
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-633-2249
Provider Business Practice Location Address Fax Number:
661-633-2244
Provider Enumeration Date:
05/27/2009