Provider First Line Business Practice Location Address:
8202 PRENTICE HALL DR
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:
93311-1749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-406-0365
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/17/2023