Provider First Line Business Practice Location Address:
610 GRACE ST
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:
93305-3703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-246-3180
Provider Business Practice Location Address Fax Number:
661-325-3929
Provider Enumeration Date:
10/22/2021