Provider First Line Business Practice Location Address:
2621 OSWELL 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:
93306
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-868-6956
Provider Business Practice Location Address Fax Number:
866-331-4283
Provider Enumeration Date:
02/09/2018