Provider First Line Business Practice Location Address:
3600 DE SOUZA PL
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-5110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-831-4533
Provider Business Practice Location Address Fax Number:
661-831-1920
Provider Enumeration Date:
06/30/2005