Provider First Line Business Practice Location Address:
1522 18TH ST STE 300
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:
93301-4433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-374-4926
Provider Business Practice Location Address Fax Number:
661-374-4965
Provider Enumeration Date:
05/22/2015