Provider First Line Business Practice Location Address:
7701 WHITE LN
Provider Second Line Business Practice Location Address:
STE D
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-396-7158
Provider Business Practice Location Address Fax Number:
661-396-7286
Provider Enumeration Date:
02/14/2006