Provider First Line Business Practice Location Address:
1207 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:
93301-5431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-304-7413
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2023