Provider First Line Business Practice Location Address:
4509 FOXBORO 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:
93309-5812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-695-3200
Provider Business Practice Location Address Fax Number:
800-691-9109
Provider Enumeration Date:
09/30/2021