Provider First Line Business Practice Location Address:
1621 CHAPALA ST APT B
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:
93101-5906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-898-1018
Provider Business Practice Location Address Fax Number:
805-898-1056
Provider Enumeration Date:
09/19/2007