Provider First Line Business Practice Location Address:
11612 BOLTHOUSE DR STE 100
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:
93311-8497
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-748-1999
Provider Business Practice Location Address Fax Number:
661-748-1815
Provider Enumeration Date:
01/08/2019