Provider First Line Business Practice Location Address:
401 19TH 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:
93301-4907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-873-5110
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2017