Provider First Line Business Practice Location Address:
12619 SCHOONER BEACH DR
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:
93311-5125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-217-2474
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/03/2023