Provider First Line Business Practice Location Address:
192 CAMINO DE VIDA 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:
93111-2225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-453-5817
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/19/2021