Provider First Line Business Practice Location Address:
3501 STOCKDALE HWY
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:
93309-2150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-398-5055
Provider Business Practice Location Address Fax Number:
661-398-5040
Provider Enumeration Date:
02/21/2017