Provider First Line Business Practice Location Address:
138 E CARRILLO 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:
93101-2111
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-620-7142
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/22/2022