Provider First Line Business Practice Location Address:
3535 SAN DIMAS ST STE 14
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:
93301-1694
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-245-4403
Provider Business Practice Location Address Fax Number:
866-609-6226
Provider Enumeration Date:
07/26/2021