Provider First Line Business Practice Location Address:
2130 CHESTER AVE STE 102
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:
93301-4472
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
866-987-5373
Provider Business Practice Location Address Fax Number:
866-987-5374
Provider Enumeration Date:
10/11/2016