Provider First Line Business Practice Location Address:
4301 DE ETTE AVE
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:
93313-2916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-619-7047
Provider Business Practice Location Address Fax Number:
661-396-2349
Provider Enumeration Date:
11/25/2020