Provider First Line Business Practice Location Address:
6219 PROVINCETOWN AVE
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:
93313-5888
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-932-8027
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2021