Provider First Line Business Practice Location Address:
629 W COTA ST APT C
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:
93101-4498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-405-3488
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/27/2023