Provider First Line Business Practice Location Address:
1964 LAS CANOAS RD
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:
93105-2351
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-623-2347
Provider Business Practice Location Address Fax Number:
323-984-9010
Provider Enumeration Date:
11/11/2016