Provider First Line Business Practice Location Address:
1400 SO UNION AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-397-8775
Provider Business Practice Location Address Fax Number:
661-397-8286
Provider Enumeration Date:
05/16/2007