Provider First Line Business Practice Location Address:
1613 CHAPALA ST APT 1
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:
93101-5966
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-284-4296
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/19/2025