Provider First Line Business Practice Location Address:
4500 SHEPARD ST STE B4
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:
93313-2334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-282-7117
Provider Business Practice Location Address Fax Number:
661-885-8014
Provider Enumeration Date:
07/01/2019