Provider First Line Business Practice Location Address:
9409 KANOSH COBBLE 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:
93313-5692
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-565-2742
Provider Business Practice Location Address Fax Number:
661-855-4409
Provider Enumeration Date:
04/12/2023