Provider First Line Business Practice Location Address:
5055 CALIFORNIA AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-0701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-635-3411
Provider Business Practice Location Address Fax Number:
661-869-6979
Provider Enumeration Date:
05/22/2012