Provider First Line Business Practice Location Address:
9730 BRIMHALL RD STE 1
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:
93312-2786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-663-0818
Provider Business Practice Location Address Fax Number:
661-663-0516
Provider Enumeration Date:
11/17/2006