Provider First Line Business Practice Location Address:
6001 TRUXTUN AVE
Provider Second Line Business Practice Location Address:
SUITE # 120
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0679
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-588-5706
Provider Business Practice Location Address Fax Number:
661-588-5706
Provider Enumeration Date:
12/29/2006