Provider First Line Business Practice Location Address:
1705 28TH 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:
93301-1902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-3008
Provider Business Practice Location Address Fax Number:
661-322-5507
Provider Enumeration Date:
09/07/2016