Provider First Line Business Practice Location Address:
208 CYPRESS 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:
93304-2417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-996-3721
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/17/2025