Provider First Line Business Practice Location Address:
5501 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
BUILDING #9762
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-2503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-610-3448
Provider Business Practice Location Address Fax Number:
661-667-4475
Provider Enumeration Date:
02/05/2013