Provider First Line Business Practice Location Address:
309 W QUINTO 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:
93105-5318
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-563-0041
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2006