Provider First Line Business Practice Location Address:
1909 16TH ST STE 1
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:
93301-5004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-381-6552
Provider Business Practice Location Address Fax Number:
661-885-7994
Provider Enumeration Date:
02/03/2021