Provider First Line Business Practice Location Address:
1601 H ST STE 102
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:
93301-5133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-747-8442
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2025