Provider First Line Business Practice Location Address:
433 T ST APT A
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:
93304-2352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-791-0814
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2025