Provider First Line Business Practice Location Address:
602 H ST # 120
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:
93304-1368
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-379-4451
Provider Business Practice Location Address Fax Number:
661-215-5311
Provider Enumeration Date:
04/23/2019