Provider First Line Business Practice Location Address:
300 OLD RIVER RD STE 200
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:
93311-9506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-664-2300
Provider Business Practice Location Address Fax Number:
661-663-6259
Provider Enumeration Date:
07/21/2017