Provider First Line Business Practice Location Address:
610 E 10TH 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:
93307-1120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-507-1032
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/12/2023