Provider First Line Business Practice Location Address:
4101 EMPIRE DR
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0681
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-325-3937
Provider Business Practice Location Address Fax Number:
661-283-3937
Provider Enumeration Date:
10/24/2006