Provider First Line Business Practice Location Address:
210 N CHESTER 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:
93308-4841
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-300-6664
Provider Business Practice Location Address Fax Number:
661-237-6650
Provider Enumeration Date:
01/11/2018