Provider First Line Business Practice Location Address:
5301 YOUNG STREET
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:
93311-8978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-734-3338
Provider Business Practice Location Address Fax Number:
856-491-4365
Provider Enumeration Date:
10/27/2022