Provider First Line Business Practice Location Address:
1015 BAKER ST UNIT 4
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:
93305-4341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-328-4283
Provider Business Practice Location Address Fax Number:
661-843-8619
Provider Enumeration Date:
07/15/2021