Provider First Line Business Practice Location Address:
627 RUSSELL WAY
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:
93110-1538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-259-6594
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/26/2007