Provider First Line Business Practice Location Address:
2323 DE LA VINA ST STE 104
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:
93105-3878
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-265-0626
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2025