Provider First Line Business Practice Location Address:
3933 COFFEE RD STE B
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:
93308-5024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-588-9999
Provider Business Practice Location Address Fax Number:
661-588-9997
Provider Enumeration Date:
07/12/2016