Provider First Line Business Practice Location Address:
4100 EMPIRE DR
Provider Second Line Business Practice Location Address:
SUITE #120
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-878-9100
Provider Business Practice Location Address Fax Number:
661-878-9101
Provider Enumeration Date:
01/18/2007