Provider First Line Business Practice Location Address:
2201 MOUNT VERNON AVE STE 110
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:
93306-3312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-840-8721
Provider Business Practice Location Address Fax Number:
661-885-6983
Provider Enumeration Date:
05/23/2016