Provider First Line Business Practice Location Address:
4040 SAN DIMAS ST STE A
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:
93301-1299
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-363-6800
Provider Business Practice Location Address Fax Number:
661-324-6874
Provider Enumeration Date:
08/05/2019