Provider First Line Business Practice Location Address:
1712 19TH ST STE 202
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:
93301-4333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-408-6860
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2022