Provider First Line Business Practice Location Address:
3628 STOCKDALE HWY
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:
93309-2153
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
661-322-1021
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2019