Provider First Line Business Practice Location Address:
400 E SANTA BARBARA ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
SANTA PAULA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93060-2675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-525-6603
Provider Business Practice Location Address Fax Number:
805-525-6115
Provider Enumeration Date:
03/02/2006