Provider First Line Business Practice Location Address:
1230 COAST VILLAGE CIR STE C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93108-0711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-565-1134
Provider Business Practice Location Address Fax Number:
805-565-2290
Provider Enumeration Date:
04/02/2007