Provider First Line Business Practice Location Address:
500 OLD RIVER RD SUITE 125
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:
93311
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-663-0977
Provider Business Practice Location Address Fax Number:
661-663-0991
Provider Enumeration Date:
08/31/2006