Provider First Line Business Practice Location Address:
210 S MONTCLAIR 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:
93309-3164
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-397-0665
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/06/2018