Provider First Line Business Practice Location Address:
111 W MICHELTORENA ST STE 210
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:
93101-8810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
424-600-7798
Provider Business Practice Location Address Fax Number:
669-777-6709
Provider Enumeration Date:
12/11/2025