Provider First Line Business Practice Location Address:
2412 ELM 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:
93301-2616
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-699-2202
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2026