Provider First Line Business Practice Location Address:
3807 SAN DIMAS ST STE C
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:
93301-1497
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-489-5537
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/12/2018