Provider First Line Business Practice Location Address:
2128 NILES ST
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:
93305-5008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-474-6686
Provider Business Practice Location Address Fax Number:
661-281-2909
Provider Enumeration Date:
01/15/2019