Provider First Line Business Practice Location Address:
1700 MOUNT VERNON AVE
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:
93306-4018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
611-326-2202
Provider Business Practice Location Address Fax Number:
661-862-7612
Provider Enumeration Date:
02/12/2016