Provider First Line Business Practice Location Address:
9500 STOCKDALE HWY
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:
93311-3620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-735-3943
Provider Business Practice Location Address Fax Number:
661-381-7594
Provider Enumeration Date:
11/30/2015