Provider First Line Business Practice Location Address:
2833 CLINTON TERRACE
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:
93105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
920-850-8941
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2005