Provider First Line Business Practice Location Address:
1522 STATE ST # 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:
93101-2514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-665-3835
Provider Business Practice Location Address Fax Number:
805-617-0228
Provider Enumeration Date:
07/21/2023