Provider First Line Business Practice Location Address:
5959 TRUXTUN AVE
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:
93309-0435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-638-0601
Provider Business Practice Location Address Fax Number:
661-638-0606
Provider Enumeration Date:
08/02/2017