Provider First Line Business Practice Location Address:
5500 MING AVE STE 410
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:
93309-4631
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-622-4132
Provider Business Practice Location Address Fax Number:
573-365-2224
Provider Enumeration Date:
05/19/2016