Provider First Line Business Practice Location Address:
5603 TAPIA CT
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:
93306-7474
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-435-8244
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2017