Provider First Line Business Practice Location Address:
2100 E ST
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:
93301-3808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-327-4252
Provider Business Practice Location Address Fax Number:
661-327-3409
Provider Enumeration Date:
06/27/2017