Provider First Line Business Practice Location Address:
3669 SAGUNTO ST
Provider Second Line Business Practice Location Address:
STE. 102
Provider Business Practice Location Address City Name:
SANTA YNEZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93460-9151
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-693-1414
Provider Business Practice Location Address Fax Number:
805-693-8006
Provider Enumeration Date:
09/21/2006