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:
661-326-2197
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/19/2022