Provider First Line Business Practice Location Address:
9500 BRIMHALL
Provider Second Line Business Practice Location Address:
SUITE 707
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-847-4772
Provider Business Practice Location Address Fax Number:
559-227-3473
Provider Enumeration Date:
05/30/2006