Provider First Line Business Practice Location Address:
4000 STOCKDALE HWY STE A
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:
93309-2059
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-324-8055
Provider Business Practice Location Address Fax Number:
661-324-7141
Provider Enumeration Date:
05/21/2007