Provider First Line Business Practice Location Address:
5596 CALLE OCHO
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARPINTERIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93013-2544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-448-0603
Provider Business Practice Location Address Fax Number:
805-563-0507
Provider Enumeration Date:
10/28/2009