Provider First Line Business Practice Location Address:
416 WASHINGTON AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CALIFORNIA
Provider Business Practice Location Address Postal Code:
93308
Provider Business Practice Location Address Country Code:
UM
Provider Business Practice Location Address Telephone Number:
661-750-9196
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2022