Provider First Line Business Practice Location Address:
5001 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:
93309-2652
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-833-1018
Provider Business Practice Location Address Fax Number:
661-833-3755
Provider Enumeration Date:
09/14/2006