Provider First Line Business Practice Location Address:
3550 Q ST STE 105
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:
93301-1645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-432-1451
Provider Business Practice Location Address Fax Number:
661-489-5040
Provider Enumeration Date:
01/22/2019