Provider First Line Business Practice Location Address:
9001 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:
93311-1022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-654-3475
Provider Business Practice Location Address Fax Number:
661-654-3970
Provider Enumeration Date:
08/10/2018