Provider First Line Business Practice Location Address:
1709 LOMA ST APT 4
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:
93103-1860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-886-8602
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/01/2009