Provider First Line Business Practice Location Address:
3720 GOSFORD RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-7695
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-831-9024
Provider Business Practice Location Address Fax Number:
661-836-1242
Provider Enumeration Date:
03/27/2015