Provider First Line Business Practice Location Address:
5001 COMMERCE DR
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:
93309-0648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-374-5457
Provider Business Practice Location Address Fax Number:
661-410-8685
Provider Enumeration Date:
07/28/2005