Provider First Line Business Practice Location Address:
5120 STOCKDALE HWY
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:
93309-2671
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-5442
Provider Business Practice Location Address Fax Number:
661-324-5445
Provider Enumeration Date:
08/22/2006