Provider First Line Business Practice Location Address:
914 ANACAPA ST
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:
93101-2101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-317-9181
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/19/2007