Provider First Line Business Practice Location Address:
11518 SCHOOL 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:
93307-9148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-366-8625
Provider Business Practice Location Address Fax Number:
661-363-4631
Provider Enumeration Date:
10/21/2019