Provider First Line Business Practice Location Address:
8150 HAGEMAN RD
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:
93312-1959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-459-1010
Provider Business Practice Location Address Fax Number:
855-200-2829
Provider Enumeration Date:
01/15/2020