Provider First Line Business Practice Location Address:
2005 RIDGE RD
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:
93305-4123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-868-4557
Provider Business Practice Location Address Fax Number:
661-868-4520
Provider Enumeration Date:
06/03/2016