Provider First Line Business Practice Location Address:
612 ANACAPA ST APT A
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:
93101-1653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-272-0020
Provider Business Practice Location Address Fax Number:
651-666-1610
Provider Enumeration Date:
07/02/2024