Provider First Line Business Practice Location Address:
3550 Q ST STE 201
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:
93301-1645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-558-1620
Provider Business Practice Location Address Fax Number:
661-558-1621
Provider Enumeration Date:
10/24/2019