Provider First Line Business Practice Location Address:
609 E 18TH 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:
93305-5616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-321-0234
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/25/2025