Provider First Line Business Practice Location Address:
1326 30TH ST UNIT B
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:
93301-2412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-371-2652
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2020