Provider First Line Business Practice Location Address:
629 STATE ST STE 249
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:
93101-7072
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-399-2472
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/28/2025