Provider First Line Business Practice Location Address:
608 ELSEY 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:
93309-1418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-803-0335
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/10/2025