Provider First Line Business Practice Location Address:
550 MAPLE ST
Provider Second Line Business Practice Location Address:
B
Provider Business Practice Location Address City Name:
CARPINTERIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93013-3559
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-275-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/11/2015