Provider First Line Business Practice Location Address:
3900 COFFEE RD
Provider Second Line Business Practice Location Address:
STE.3
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93308-5049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-588-5808
Provider Business Practice Location Address Fax Number:
661-615-6515
Provider Enumeration Date:
06/01/2010