Provider First Line Business Practice Location Address:
2613 DEERBROOK 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:
93308-5622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-593-1224
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/17/2022