Provider First Line Business Practice Location Address:
425A W LOS OLIVOS ST
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:
93105-4214
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-377-1760
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2018