Provider First Line Business Practice Location Address:
1010 ANACAPA 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:
93101-2103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-315-6143
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/29/2019