Provider First Line Business Practice Location Address:
2229 19TH 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:
93301-3608
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-213-8517
Provider Business Practice Location Address Fax Number:
909-727-8223
Provider Enumeration Date:
10/18/2020