Provider First Line Business Practice Location Address:
14800 HUCKLEBERRY DR
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:
93314-9881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-504-5467
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/24/2026