Provider First Line Business Practice Location Address:
4000 EASTON DR
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-9416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-323-1843
Provider Business Practice Location Address Fax Number:
661-323-8333
Provider Enumeration Date:
05/21/2007