Provider First Line Business Practice Location Address:
300 OLD RIVER RD
Provider Second Line Business Practice Location Address:
SUITE 165
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-663-3110
Provider Business Practice Location Address Fax Number:
661-663-3171
Provider Enumeration Date:
10/05/2006