Provider First Line Business Practice Location Address:
836 ANACAPA ST
Provider Second Line Business Practice Location Address:
SUITE 20176
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93102-9989
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-455-9727
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/15/2012