Provider First Line Business Practice Location Address:
2525 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:
93308-1770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-991-5272
Provider Business Practice Location Address Fax Number:
661-868-1839
Provider Enumeration Date:
08/11/2016