Provider First Line Business Practice Location Address:
2311 21ST 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:
93301-3511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-809-7501
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/20/2018