Provider First Line Business Practice Location Address:
952 MIRAMONTE DR
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93109-1307
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-966-9683
Provider Business Practice Location Address Fax Number:
805-560-6969
Provider Enumeration Date:
08/30/2006