Provider First Line Business Practice Location Address:
2728 MING 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:
93304-4431
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-587-2468
Provider Business Practice Location Address Fax Number:
661-587-6403
Provider Enumeration Date:
01/29/2018