Provider First Line Business Practice Location Address:
4504 COLUMBUS 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:
93306-1213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-302-6622
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2023