Provider First Line Business Practice Location Address:
1715 30TH 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:
93301-1909
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-514-0004
Provider Business Practice Location Address Fax Number:
661-514-0005
Provider Enumeration Date:
05/16/2022