Provider First Line Business Practice Location Address:
1111 COLUMBUS ST
Provider Second Line Business Practice Location Address:
SUITE 1200
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93305-1936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-326-5056
Provider Business Practice Location Address Fax Number:
661-862-7635
Provider Enumeration Date:
03/20/2012