Provider First Line Business Practice Location Address:
1309 CALLE PODEROSA
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:
93309-7150
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-900-2042
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/07/2022