Provider First Line Business Practice Location Address:
3933 COFFEE RD STE B
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:
93308-5024
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-228-6600
Provider Business Practice Location Address Fax Number:
559-226-3709
Provider Enumeration Date:
11/29/2008