Provider First Line Business Practice Location Address:
1214 COAST VILLAGE RD
Provider Second Line Business Practice Location Address:
SUITE 5
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93108
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-969-4382
Provider Business Practice Location Address Fax Number:
805-284-9556
Provider Enumeration Date:
08/23/2005