Provider First Line Business Practice Location Address:
1601 NEW STINE RD STE 110
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:
93309-3698
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-317-9565
Provider Business Practice Location Address Fax Number:
818-721-8009
Provider Enumeration Date:
02/01/2022