Provider First Line Business Practice Location Address:
4100 EMPIRE DR STE 120
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:
93309-0408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-328-5565
Provider Business Practice Location Address Fax Number:
805-328-5573
Provider Enumeration Date:
02/02/2018