Provider First Line Business Practice Location Address:
1155 COAST VILLAGE RD BLDG C
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:
93108-2728
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-548-3270
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/16/2020