Provider First Line Business Practice Location Address:
5357 TRUXTUN AVE
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:
93309-0641
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-868-1012
Provider Business Practice Location Address Fax Number:
661-247-8379
Provider Enumeration Date:
03/14/2017