Provider First Line Business Practice Location Address:
9905 BACE AVE
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:
93307-6211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-831-1100
Provider Business Practice Location Address Fax Number:
661-831-8279
Provider Enumeration Date:
02/27/2019