Provider First Line Business Practice Location Address:
3900 COFFEE RD
Provider Second Line Business Practice Location Address:
SUITE 3
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93308-5049
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-587-0700
Provider Business Practice Location Address Fax Number:
661-587-9131
Provider Enumeration Date:
12/15/2005