Provider First Line Business Practice Location Address:
1300 BAKER 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:
93305-4326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-631-5895
Provider Business Practice Location Address Fax Number:
661-631-5898
Provider Enumeration Date:
01/04/2019