Provider First Line Business Practice Location Address:
3857 STOCKDALE HWY
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:
93309-2187
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-832-1667
Provider Business Practice Location Address Fax Number:
661-832-7145
Provider Enumeration Date:
09/13/2005