Provider First Line Business Practice Location Address:
2317 17TH ST
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:
93301-3503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-213-9179
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2018