Provider First Line Business Practice Location Address:
4600 AMERICAN AVENUE, EAST
Provider Second Line Business Practice Location Address:
STE. 101
Provider Business Practice Location Address City Name:
BAKERSFIELD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-833-4483
Provider Business Practice Location Address Fax Number:
661-833-4481
Provider Enumeration Date:
11/21/2016