Provider First Line Business Practice Location Address:
4823 VIA LOS SANTOS
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:
93111-1329
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-964-4130
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/18/2010