Provider First Line Business Practice Location Address:
1723 27TH 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:
93301-2807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-499-3594
Provider Business Practice Location Address Fax Number:
855-678-4600
Provider Enumeration Date:
01/12/2021