Provider First Line Business Practice Location Address:
4500 TRADE CENTER DR 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:
93311-8716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-348-7253
Provider Business Practice Location Address Fax Number:
818-348-7012
Provider Enumeration Date:
08/16/2017