Provider First Line Business Practice Location Address:
4325 BUENA VISTA RD
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:
93311-8701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-858-8519
Provider Business Practice Location Address Fax Number:
661-410-1110
Provider Enumeration Date:
08/07/2023