Provider First Line Business Practice Location Address:
1205 SAN MIGUEL AVE
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:
93109-2134
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-249-1593
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2016