Provider First Line Business Practice Location Address:
2850 BASELINE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA YNEZ
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93460-9354
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-688-2730
Provider Business Practice Location Address Fax Number:
805-688-0336
Provider Enumeration Date:
04/17/2007