Provider First Line Business Practice Location Address:
3845 STOCKDALE HWY
Provider Second Line Business Practice Location Address:
SUITE 17
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309-3192
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-364-7800
Provider Business Practice Location Address Fax Number:
661-364-7800
Provider Enumeration Date:
03/14/2014