Provider First Line Business Practice Location Address:
539 SAN YSIDRO RD FL 2
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:
93108-2195
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-698-6959
Provider Business Practice Location Address Fax Number:
805-967-5646
Provider Enumeration Date:
10/16/2006