Provider First Line Business Practice Location Address:
136 ALLEN RD STE 100-1007
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:
93314-3710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-451-6391
Provider Business Practice Location Address Fax Number:
619-314-5141
Provider Enumeration Date:
02/14/2023